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1

Trimodality therapy of esophagectomy plus neoadjuvant chemoradiotherapy improves the survival of clinical stage II/III esophageal squamous cell carcinoma patients  

PubMed Central

The prognosis of advanced esophageal cancer patients is poor. Trimodality therapy of surgical resection plus neoadjuvant chemoradiotherapy (CRT) has been developed to improve survival through locoregional control, leading to prevention of micrometastasis. We investigated whether or not neoadjuvant CRT led to survival benefits in TNM stage II/III esophageal cancer patients. We retrospectively reviewed 62 patients with stage II or III esophageal squamous cell carcinoma (ESCC) treated with neoadjuvant CRT. All patients received esophagectomy 4–7 weeks after CRT consisting of 40 Gy irradiation and chemotherapy (5-FU, 500 mg/m2/day, days 1–5 and cisplatin, 10–20 mg/body, days 1–5). Clinical response and survival rates were analyzed using Kaplan-Meier methods, with P<0.05 considered as significant. The clinical effect rate of CRT for both primary tumors and metastatic nodes was 82.3%. Operative and hospital mortality rates were 1.65 and 6.5%, respectively. The 3-year overall survival (OS) and disease-free survival (DFS) rates were 52.6 and 49.2%, respectively. A significant difference was noted between stages II and III for both OS and DFS. The 5-year OS rates were 64.2% for stage II, 33.1% for stage III (T4 and non-T4) and 46.9% for stage III (non-T4 only) patients. The depth of tumor invasion (T3 vs. T4), resectability (R0 vs. R1, R2), lymph node metastasis (positive vs. negative), and the effect of CRT were proven to be independent prognostic factors for univariate analysis, with resectability and the effect of CRT for multivariate analysis. These data suggest that CRT in stage II/III (non-T4) ESCC patient contributed to tumor shrinkage, leading to higher resectability and longer survival. Neoadjuvant CRT appears to be a promising option for these patients.

FUJIWARA, YOSHINORI; YOSHIKAWA, REIGETSU; KAMIKONYA, NORIHIKO; NAKAYAMA, TSUYOSHI; KITANI, KOTARO; TSUJIE, MASANORI; YUKAWA, MASAO; INOUE, MASATOSHI; YAMAMURA, TAKEHIRA

2012-01-01

2

Staging of Esophageal Cancer  

Microsoft Academic Search

Esophageal carcinoma is the fifth most common gastrointestinal cancer, and the recent data suggests that it is rising in incidence\\u000a faster than any other malignancy. Although esophageal carcinoma is generally felt to have a poor prognosis, this is largely\\u000a owing to the heterogeneity of patients. As with any malignancy, the stage of the tumor predicts prognosis and determines treatment\\u000a options.

Jason Vollweiler; Gregory Zuccaro

3

Esophageal Cancer: Initial Staging  

Microsoft Academic Search

The incidence of esophageal cancer is increasing. Worldwide it is the ninth most common malignancy and is endemic in many\\u000a parts of the world, particularly in the developing countries. There were 14,550 new cases and 13,770 deaths from esophageal\\u000a cancer in the United States in 2006. Esophageal cancer has two pathological subtypes: squamous cell carcinoma and adenocarcinoma.\\u000a Squamous cell carcinoma

Lana Y. Schumacher; Nicole B. Baril; Sherry M. Wren

4

The Activity of Class I, II, III, and IV Alcohol Dehydrogenase (ADH) Isoenzymes and Aldehyde Dehydrogenase (ALDH) in Esophageal Cancer  

Microsoft Academic Search

Background\\/Aims Ethanol consumption is associated with an increased risk of esophageal cancer. The carcinogenic compound is acetaldehyde,\\u000a the product of ethanol metabolism. Alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH) are the main enzymes involved\\u000a in ethanol metabolism, which leads to generation of acetaldehyde. In this study the activity of ADH isoenzymes and ALDH in\\u000a esophageal cancer were compared with the

Wojciech Jelski; Miroslaw Kozlowski; Jerzy Laudanski; Jacek Niklinski; Maciej Szmitkowski

2009-01-01

5

Preoperative Staging for Esophageal Carcinoma  

Microsoft Academic Search

Squamous carcinoma of the esophagus must be accurately staged before treatment. Although multimodality therapy is the current\\u000a standard of care, the timing of surgery with respect to chemotherapy and radiation depends critically on the stage of disease.\\u000a Staging modalities include laparoscopy, thoracoscopy, computed tomography (CT), magnetic resonance imaging (MRI), positron\\u000a emission tomography (PET), and endoscopic ultrasound. In this chapter, several

Samuel M. Maurice; Beate Rau; Prasad S. Adusumilli; Amit N. Patel

6

Epidemiology, Diagnosis, and Staging of Esophageal Cancer  

Microsoft Academic Search

\\u000a Esophageal carcinoma is an uncommon gastrointestinal malignancy with a prevalence rate which is far less than the more common\\u000a colo-rectal cancers. Whereas the overall incidence of esophageal cancer has risen only gradually with time, in the United\\u000a States, Canada, and Western Europe, there has been a dramatic change in the distribution of esophageal cancer by cell type\\u000a (figure 1). Currently

f. Richard; m. d. Heitmiller

7

Update on Staging and Surgical Treatment Options for Esophageal Cancer  

Microsoft Academic Search

Introduction  Esophageal cancer remains a challenging clinical problem, with overall long-term survivorship consistently at a level of approximately\\u000a 30%. The incidence of esophageal cancer is increasing worldwide, with the most dramatic increase being seen with respect to\\u000a esophageal adenocarcinoma.\\u000a \\u000a \\u000a \\u000a \\u000a Discussion  Pretreatment staging accuracy has improved with the utilization of CT and PET scans, as well as endoscopic ultrasound and\\u000a endoscopic mucosal resection.

Donald E. Low

2011-01-01

8

Bevacizumab, Fluorouracil, Leucovorin Calcium, and Oxaliplatin Before Surgery in Treating Patients With Stage II-III Rectal Cancer  

ClinicalTrials.gov

Mucinous Adenocarcinoma of the Rectum; Signet Ring Adenocarcinoma of the Rectum; Stage IIA Rectal Cancer; Stage IIB Rectal Cancer; Stage IIC Rectal Cancer; Stage IIIA Rectal Cancer; Stage IIIB Rectal Cancer; Stage IIIC Rectal Cancer

2013-07-31

9

Cyclophosphamide and Vaccine Therapy in Treating Patients With Stage II-III Breast, Ovarian, Primary Peritoneal, or Fallopian Tube Cancer  

ClinicalTrials.gov

Recurrent Breast Cancer; Recurrent Fallopian Tube Cancer; Recurrent Ovarian Epithelial Cancer; Recurrent Ovarian Germ Cell Tumor; Recurrent Primary Peritoneal Cavity Cancer; Stage IIA Ovarian Epithelial Cancer; Stage IIA Ovarian Germ Cell Tumor; Stage IIA Primary Peritoneal Cavity Cancer; Stage IIB Ovarian Epithelial Cancer; Stage IIB Ovarian Germ Cell Tumor; Stage IIB Primary Peritoneal Cavity Cancer; Stage IIC Ovarian Epithelial Cancer; Stage IIC Ovarian Germ Cell Tumor; Stage IIC Primary Peritoneal Cavity Cancer; Stage IIIA Breast Cancer; Stage IIIA Ovarian Epithelial Cancer; Stage IIIA Ovarian Germ Cell Tumor; Stage IIIA Primary Peritoneal Cavity Cancer; Stage IIIB Breast Cancer; Stage IIIB Ovarian Epithelial Cancer; Stage IIIB Ovarian Germ Cell Tumor; Stage IIIB Primary Peritoneal Cavity Cancer; Stage IIIC Breast Cancer; Stage IIIC Ovarian Epithelial Cancer; Stage IIIC Ovarian Germ Cell Tumor; Stage IIIC Primary Peritoneal Cavity Cancer

2013-06-14

10

Fulvestrant and/or Anastrozole in Treating Postmenopausal Patients With Stage II-III Breast Cancer Undergoing Surgery  

ClinicalTrials.gov

Estrogen Receptor-positive Breast Cancer; HER2-negative Breast Cancer; Invasive Ductal Breast Carcinoma; Invasive Lobular Breast Carcinoma; Recurrent Breast Cancer; Stage II Breast Cancer; Stage IIIA Breast Cancer; Stage IIIB Breast Cancer; Stage IIIC Breast Cancer

2013-10-08

11

Endoscopic ultrasound for preoperative staging of esophageal carcinoma  

Microsoft Academic Search

Background  Endoscopic ultrasound (EUS) is potentially the best method for pretreatment staging of esophageal carcinoma once distant metastases\\u000a have been excluded by other methods. However, its apparent accuracy might be influenced by the use of neoadjuvant therapy.\\u000a To determine the accuracy of EUS in patients undergoing esophageal resection, the authors reviewed their experience with EUS.\\u000a \\u000a \\u000a \\u000a Methods  A total of 73 patients with

X. Zhang; D. I. Watson; C. Lally; J. R. Bessell

2005-01-01

12

Effect of Postmastectomy Radiotherapy in Patients <35 Years Old With Stage II-III Breast Cancer Treated With Doxorubicin-Based Neoadjuvant Chemotherapy and Mastectomy  

SciTech Connect

Purpose: Postmastectomy radiotherapy (PMRT) improves locoregional control (LRC) in patients with high-risk features after mastectomy. Young age continues to evolve as a potentially important risk factor. The objective of this study was to assess the benefits of PMRT in patients <35 years old treated with doxorubicin-based neoadjuvant chemotherapy for Stage II-III breast cancer. Patients and Methods: We retrospectively analyzed 107 consecutive breast cancer patients <35 years old with Stage IIA-IIIC disease treated at our institution with doxorubicin-based neoadjuvant chemotherapy and mastectomy, with or without PMRT. The treatment groups were compared in terms of LRC and overall survival. Results: Despite more advanced disease stages, the patients who received PMRT (n = 80) had greater rates of LRC (5-year rate, 88% vs. 63%, p = 0.001) and better overall survival (5-year rate, 67% vs. 48%, p = 0.03) than patients who did not receive PMRT (n = 27). Conclusion: Among breast cancer patients <35 years old at diagnosis, the use of PMRT after doxorubicin-based neoadjuvant chemotherapy and mastectomy led to a statistically greater rate of LRC and overall survival compared with patients without PMRT. The benefit seen for PMRT in young patients provides valuable data to better tailor adjuvant, age-specific treatment decisions after mastectomy.

Garg, Amit K. [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Oh, Julia L. [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States)], E-mail: joh@mdanderson.org; Oswald, Mary Jane; Huang, Eugene; Strom, Eric A.; Perkins, George H.; Woodward, Wendy A.; Yu, T. Kuan; Tereffe, Welela [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Meric-Bernstam, Funda [Department of Surgical Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Hahn, Karin [Department of Breast Medical Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Buchholz, Thomas A. [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States)

2007-12-01

13

Computed tomography for staging esophageal and gastroesophageal cancer: reevaluation  

SciTech Connect

A reevaluation of computed tomography (CT) for staging carcinoma of the esophagus and gastroesophageal junction was performed in 76 patients. For comparison 26 patients without carcinoma of the esophagus with a normal mediastinum at surgery were included in the evaluation. Four radiologists evaluated the CT scans without knowledge of the diagnosis. After determining if there was an adequate amount of fat, they were asked to evaluate each case for the presence or absence of local invasion and distant metastases. The radiologists correctly identified all 26 normal patients. Eighteen of the 76 carcinoma had a paucity of fat, but only six were thought to have truly indeterminate scans. CT correctly identified 40 of the 44 esophageal carcinoma patients with mediastinal invasion and 11 of the 15 patients without invasion (accuracy 88%). CT correctly identified 15 of 19 patients with distant abdominal metastases and 28 of 30 patients without metastases (accuracy 88%). CT was only 50% accurate in predicting the presence or absence of invasion in the 12 patients with gastroesophageal junction tumors and only 58% accurate in predicting distant metastases. CT correctly staged 46(94%) of 49 patients with esophageal carcinoma but only five (42%) of 12 patients with gastroesophageal junction tumors. These results confirm that CT should be used as a major staging method in all patients with esophageal carcinoma.

Thompson, W.M.; Halvorsen, R.A.; Foster, W.L. Jr.; Williford, M.E.; Postlethwait, R.W.; Korobkin, M.

1983-11-01

14

Mastectomy With Immediate Expander-Implant Reconstruction, Adjuvant Chemotherapy, and Radiation for Stage II-III Breast Cancer: Treatment Intervals and Clinical Outcomes  

SciTech Connect

Purpose: To determine intervals between surgery and adjuvant chemotherapy and radiation in patients treated with mastectomy with immediate expander-implant reconstruction, and to evaluate locoregional and distant control and overall survival in these patients. Methods and Materials: Between May 1996 and March 2004, 104 patients with Stage II-III breast cancer were routinely treated at our institution under the following algorithm: (1) definitive mastectomy with axillary lymph node dissection and immediate tissue expander placement, (2) tissue expansion during chemotherapy, (3) exchange of tissue expander for permanent implant, (4) radiation. Patient, disease, and treatment characteristics and clinical outcomes were retrospectively evaluated. Results: Median age was 45 years. Twenty-six percent of patients were Stage II and 74% Stage III. All received adjuvant chemotherapy. Estrogen receptor staining was positive in 77%, and 78% received hormone therapy. Radiation was delivered to the chest wall with daily 0.5-cm bolus and to the supraclavicular fossa. Median dose was 5040 cGy. Median interval from surgery to chemotherapy was 5 weeks, from completion of chemotherapy to exchange 4 weeks, and from exchange to radiation 4 weeks. Median interval from completion of chemotherapy to start of radiation was 8 weeks. Median follow-up was 64 months from date of mastectomy. The 5-year rate for locoregional disease control was 100%, for distant metastasis-free survival 90%, and for overall survival 96%. Conclusions: Mastectomy with immediate expander-implant reconstruction, adjuvant chemotherapy, and radiation results in a median interval of 8 weeks from completion of chemotherapy to initiation of radiation and seems to be associated with acceptable 5-year locoregional control, distant metastasis-free survival, and overall survival.

Wright, Jean L. [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Cordeiro, Peter G. [Department of Surgery, Plastic and Reconstructive Service, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Ben-Porat, Leah [Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Van Zee, Kimberly J. [Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Hudis, Clifford [Department of Medicine, Solid Tumor Division, Breast Cancer Medicine Service, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Beal, Kathryn [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); McCormick, Beryl [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States)], E-mail: mccormib@mskcc.org

2008-01-01

15

Prognostic Impact of Erythropoietin Expression and Erythropoietin Receptor Expression on Locoregional Control and Survival of Patients Irradiated for Stage II/III Non-Small-Cell Lung Cancer  

SciTech Connect

Purpose: Prognostic factors can guide the physician in selecting the optimal treatment for an individual patient. This study investigates the prognostic value of erythropoietin (EPO) and EPO receptor (EPO-R) expression of tumor cells for locoregional control and survival in non-small-cell lung cancer (NSCLC) patients. Methods and Materials: Fourteen factors were investigated in 62 patients irradiated for stage II/III NSCLC, as follows: age, gender, Karnofsky performance score (KPS), histology, grading, TNM/American Joint Committee on Cancer (AJCC) stage, surgery, chemotherapy, pack years (average number of packages of cigarettes smoked per day multiplied by the number of years smoked), smoking during radiotherapy, hemoglobin levels during radiotherapy, EPO expression, and EPO-R expression. Additionally, patients with tumors expressing both EPO and EPO-R were compared to those expressing either EPO or EPO-R and to those expressing neither EPO nor EPO-R. Results: On univariate analysis, improved locoregional control was associated with AJCC stage II cancer (p < 0.048), surgery (p < 0.042), no smoking during radiotherapy (p = 0.024), and no EPO expression (p = 0.001). A trend was observed for a KPS of >70 (p = 0.08), an N stage of 0 to 1 (p = 0.07), and no EPO-R expression (p = 0.10). On multivariate analysis, AJCC stage II and no EPO expression remained significant. No smoking during radiotherapy was almost significant. On univariate analysis, improved survival was associated with N stage 0 to 1 (p = 0.009), surgery (p = 0.039), hemoglobin levels of {>=}12 g/d (p = 0.016), and no EPO expression (p = 0.001). On multivariate analysis, N stage 0 to 1 and no EPO expression maintained significance. Hemoglobin levels of {>=}12 g/d were almost significant. On subgroup analyses, patients with tumors expressing both EPO and EPO-R had worse outcomes than those expressing either EPO or EPO-R and those expressing neither EPO nor RPO-R. Conclusions: EPO expression of tumor cells was an independent prognostic factor for locoregional control and survival in patients irradiated for NSCLC. EPO-R expression showed a trend. Patients with tumors expressing both EPO and EPO-R have an unfavorable prognosis.

Rades, Dirk, E-mail: Rades.Dirk@gmx.ne [Department of Radiation Oncology, University of Lubeck (Germany); Setter, Cornelia [Department of Radiation Oncology, University of Lubeck (Germany); Dahl, Olav [Section of Oncology, Institute of Medicine, University of Bergen, Bergen (Norway); Department of Oncology, Haukeland University Hospital, Bergen (Norway); Schild, Steven E. [Department of Radiation Oncology, Mayo Clinic Scottsdale, Arizona (United States); Noack, Frank [Institute of Pathology, University of Lubeck, Lubeck (Germany)

2011-06-01

16

Safety of zoledronic acid and incidence of osteonecrosis of the jaw (ONJ) during adjuvant therapy in a randomised phase III trial (AZURE: BIG 01–04) for women with stage II\\/III breast cancer  

Microsoft Academic Search

The AZURE trial is an ongoing phase III, academic, multi-centre, randomised trial designed to evaluate the role of zoledronic\\u000a acid (ZOL) in the adjuvant therapy of women with stage II\\/III breast cancer. Here, we report the safety and tolerability profile\\u000a of ZOL in this setting. Eligible patients received (neo)adjuvant chemotherapy and\\/or endocrine therapy and were randomised\\u000a to receive neither additional

R. Coleman; E. Woodward; J. Brown; D. Cameron; R. Bell; D. Dodwell; M. Keane; M. Gil; C. Davies; R. Burkinshaw; S. J. Houston; R. J. Grieve; P. J. Barrett-Lee; H. Thorpe

2011-01-01

17

Preoperative staging of esophageal carcinoma with multidetector CT and virtual endoscopy  

Microsoft Academic Search

PurposeThe aim of this study was to assess the accuracy of multidetector computed tomography (MDCT), including virtual endoscopy (VE) for detection, precise localization, preoperative evaluation and staging of esophageal cancer (EC) by comparison with surgical and histopathological findings.

Omer Onba?; Atilla Eroglu; Mecit Kantarci; Pinar Polat; Fatih Alper; Nurettin Karaoglanoglu; Adnan Okur

2006-01-01

18

Positron Emission Tomography for Staging Esophageal Cancer: Does It Lead to a Different Therapeutic Approach?  

Microsoft Academic Search

Accurate preoperative staging is essential for the indication and selection of the appropriate surgical procedure in patients with esophageal cancer. The present prospective study was designed to determine if the preoperative use of 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) increases the accuracy of staging esophageal cancer compared with computed tomography (CT) and if it thereby leads to a different therapeutic approach.

Werner Kneist; Mathias Schreckenberger; Peter Bartenstein; Frank Grünwald; Katja Oberholzer; Theodor Junginger

2003-01-01

19

The Prognosis of Esophageal Carcinoma Staged Irresectable (T4) by Endosonography  

Microsoft Academic Search

Background: Endosonography is an accurate preoperative staging technique for esophageal carcinoma. We retrospectively investigated a cohort of patients with carcinoma of the esophagus or gastric cardia that was endosonographically staged to be irresectable and studied whether their survival was influenced by the treatment received.Study Design: Between April 1992 and July 1995, 654 patients were referred for endosonographic staging. We retrospectively

Paul Fockens; Karolien Kisman; Maruschka P Merkus; J. Jan B van Lanschot; Hugo Obertop; Guido N. J Tytgat

1998-01-01

20

Esophagitis  

MedlinePLUS

... resulting in a chemical burn of the esophagus. Eating disorders - Similar to acid reflux, frequent vomiting can cause ... esophagus. Esophagitis sometimes is seen in people with eating disorders such as bulimia. Medications - Some common medications also ...

21

Through-the-Scope Balloon Dilation for EUS Staging of Stenosing Esophageal Cancer  

PubMed Central

Background Dilation of malignant esophageal strictures is often required to complete staging by EUS. The aim of this study is to determine the successful dilation rate (ability to complete staging) and complication rate of TTS balloon dilation for malignant esophageal strictures during EUS. Methods We retrospectively reviewed EUS reports for all cases of primary esophageal cancer staged at five centers between 1/2002 and 10/2004. All dilations were performed with TTS balloons (Boston Scientific, Natick, MA). Results Among 272 EUSs, dilation was required in 77 (28%) and was successful in 73 cases (95%). There was one esophageal perforation following dilation (1.3%; 95%CI 0.2-7.0) and one esophageal perforation following EUS without dilation (0.5%; 95%CI 0.1-2.8; p=0.48 by 2-sided Fisher's Exact test). There were no other major complications. Conclusions TTS balloon dilation is highly successful in permitting complete staging of obstructing tumors. The rate of complications following dilation with a TTS balloon dilator is low and similar to the baseline rate of EUS in this setting.

Jacobson, Brian C.; Shami, Vanessa M.; Faigel, Douglas O.; Larghi, Alberto; Kahaleh, Michel; Dye, Charles; Pedrosa, Marcos; Waxman, Irving

2010-01-01

22

Prognostic impact of clinicopathologic parameters in stage II\\/III breast cancer treated with neoadjuvant docetaxel and doxorubicin chemotherapy: paradoxical features of the triple negative breast cancer  

Microsoft Academic Search

BACKGROUND: Prognostic factors in locally advanced breast cancer treated with neoadjuvant chemotherapy differ from those of early breast cancer. The purpose of this study was to identify the clinical significance of potential predictive and prognostic factors in breast cancer patients treated by neoadjuvant chemotherapy. METHODS: A total of 145 stage II and III breast cancer patients received neoadjuvant docetaxel\\/doxorubicin chemotherapy

Bhumsuk Keam; Seock-Ah Im; Hee-Jun Kim; Do-Youn Oh; Jee Hyun Kim; Se-Hoon Lee; Eui Kyu Chie; Wonshik Han; Dong-Wan Kim; Woo Kyung Moon; Tae-You Kim; In Ae Park; Dong-Young Noh; Dae Seog Heo; Sung Whan Ha; Yung-Jue Bang

2007-01-01

23

Multimodality imaging evaluation of esophageal cancer: staging, therapy assessment, and complications.  

PubMed

Esophageal cancer is among the leading causes of cancer-related deaths worldwide. The management of patients with esophageal cancer is determined to a large extent by patient performance status, location of the primary cancer, and stage of disease at presentation. Multimodality regimens combining neoadjuvant chemotherapy and/or radiotherapy followed by surgery have been increasingly used in suitable candidates with locally advanced cancer. There is substantial morbidity and mortality associated with this treatment strategy, which makes appropriate patient selection important. Endoscopic esophageal ultrasound is the optimal modality to evaluate the local extent of the primary tumor and diagnose locoregional nodal metastasis. Computed tomography is more useful in detecting distant nodal and systemic metastasis. Positron emission tomography/CT is increasingly being used in patient management and improves the accuracy of staging, particularly in the detection of distant nodal and systemic metastatic disease. In this article, we review the role of imaging in the staging, assessment of therapeutic response, and detection of recurrent disease, as well as the evaluation of therapeutic complications in patients with esophageal cancer. PMID:23677485

Godoy, Myrna C B; Bruzzi, John F; Viswanathan, Chitra; Truong, Mylene T; Guimarães, Marcos D; Hofstetter, Wayne L; Erasmus, Jeremy J; Marom, Edith M

2013-10-01

24

Comparison of Positron Emission Tomography, Computed Tomography, and Endoscopic Ultrasound in the Initial Staging of Patients with Esophageal Cancer  

Microsoft Academic Search

Introduction  Improvement in esophageal cancer staging is needed. Positron emission tomography (PET), computed tomography (CT), and endoscopic\\u000a ultrasound (EUS) in the staging of esophageal carcinoma were compared.\\u000a \\u000a \\u000a \\u000a Methods  PET, CT, and EUS were performed and interpreted prospectively in 75 patients with newly diagnosed esophageal cancer. Either\\u000a tissue confirmation or fine needle aspiration (FNA) was used as the gold standard of disease. Sensitivity

Val J. Lowe; Fargol Booya; J. G. Fletcher; Mark Nathan; Eric Jensen; Brian Mullan; Eric Rohren; Maurits J. Wiersema; Enrique Vazquez-Sequeiros; Joseph A. Murray; Mark S. Allen; Michael J. Levy; Jonathan E. Clain

2005-01-01

25

[One-stage total and intrapleural esophagoplasty in cancer and benign esophageal strictures].  

PubMed

The authors compared the results of one-stage intrapleural (114 patients) and total esophagoplasty (214 patients). The immediate postoperative results are better in total esophagoplasty both in carcinoma and in benign strictures of the esophagus. Incompetence of the esophageal anastomosis is much less dangerous on the neck than in the pleural cavity. The authors recommend wider performance of total plastics of the esophagus with its replacement by an isoperistaltic gastric tube. PMID:1764314

Chernousov, A F; Domrachev, S A

1991-11-01

26

The Role of Endoscopic Ultrasonography in T Staging: Early Gastric Cancer and Esophageal Cancer  

PubMed Central

While a number of diagnostic methods have been developed, endoscopic ultrasound (EUS) still takes the most important role in the preoperative evaluation of esophageal cancer. EUS can detect lesions of all esophageal cancer and can accurately perform T staging. In a recent meta-analysis of EUS in esophageal cancer, the sensitivity and specificity of EUS on esophageal cancer were 81.6% and 99.4% in T1, 81.4% and 96.3% in T2, 91.4% and 94.4% in T3, and 92.4% and 97.4% in T4, respectively. The use of EUS can reduce unnecessary surgeries and lead to apply proper treatments to patients. The advance of endoscopic submucosal dissection have necessitated the presurgical detection of early cancer lesions without lymph node metastasis. Understanding the practical meanings of images shown by EUS is important to decide patients for whom endoscopic treatments can be effective. In early gastric cancer, EUS can accurately predict mucosal and SM1 (invasion into the submucosal layer of less than 500 µm from muscularis mucosa) lesions, which are considered as good indications for endoscopic treatments.

2013-01-01

27

Positron emission tomography with F-18-fluorodeoxyglucose in a combined staging strategy of esophageal cancer prevents unnecessary surgical explorations  

Microsoft Academic Search

Distant metastases or local invasion are frequently found during the explorative phase of surgery for esophageal cancer. This\\u000a study was performed to determine the rate of patients with incurable disease encountered during exploration and to examine\\u000a the impact of preoperative staging, including positron emission tomography (PET), on the number of unnecessary explorations.\\u000a The records of 203 patients with esophageal cancer

Henderik L. van Westreenen; Pierre A. M. Heeren; Hendrik M. van Dullemen; Eric J. van der Jagt; Pieter L. Jager; Henk Groen; John Th. M. Plukker

2005-01-01

28

Synchronous primary neoplasms detected on 18F-FDG PET in staging of patients with esophageal cancer  

Microsoft Academic Search

Because of improvements in diagnostic technology, the inci- dental detection of synchronous primary tumors during the preoperative work-up of patients with esophageal cancer has increased. The aim of this study was to determine the rate and clinical relevance of synchronous neoplasms seen on 18F-FDG PET in staging of esophageal cancer. Methods: From January 1996 to July 2004, 366 patients with

Westreenen van H. L; Marinke Westerterp; Pieter L. Jager; Dullemen van H. M; Gerrit W. Sloof; Emile F. I. Comans; Lanschot van J. J. B; T. Wiggers; J. T. M. Plukker

2005-01-01

29

Radiation Therapy, Paclitaxel, and Carboplatin With or Without Trastuzumab in Treating Patients With Esophageal Cancer  

ClinicalTrials.gov

Adenocarcinoma of the Esophagus; Adenocarcinoma of the Gastroesophageal Junction; Stage IB Esophageal Cancer; Stage IIA Esophageal Cancer; Stage IIB Esophageal Cancer; Stage IIIA Esophageal Cancer; Stage IIIB Esophageal Cancer

2013-10-07

30

Comparative study between endoscopic ultrasonography and positron emission tomography-computed tomography in staging patients with esophageal squamous cell carcinoma.  

PubMed

Treatment strategy of esophageal cancer mainly depends on accurate staging. At present, no single ideal staging modality is superior to another in preoperative tumor-node-metastasis (TNM) staging of patients with esophageal cancer. We aimed to investigate the efficacy of endoscopic ultrasonography (EUS) and positron emission tomography-computed tomography (PET-CT) for staging of esophageal cancer. We retrospectively studied 118 consecutive patients with esophageal squamous cell carcinoma who underwent esophagectomy with or without neoadjuvant chemoradiotherapy (CRT) over a near 3-year period between January 2005 and November 2008 at a tertiary hospital in Taiwan. Patients were separated into two groups: without neoadjuvant CRT (group 1, n= 28) and with CRT (group 2, n= 90). Medical records of demographic data and reports of EUS and PET-CT of patients before surgery were reviewed. A database of clinical staging by EUS and PET-CT was compared with one of pathological staging. The accuracies of T staging by EUS in groups 1 and 2 were 85.2% and 34.9%. The accuracies of N staging by EUS in groups 1 and 2 were 55.6% and 39.8%. The accuracies of T and N staging by means of PET-CT scan were 100% and 54.5% in group 1, and were 69.4% and 86.1% in group 2, respectively. In group 2, 38 of 90 patients (42.2%) achieved pathologic complete remission. Among them, two of 34 (5.9%) and 12 of 17 (70.6%) patients were identified as tumor-free by post-CRT EUS and PET-CT, respectively. EUS is useful for initial staging of esophageal cancer. PET-CT is a more reliable modality for monitoring treatment response and restaging. Furthermore, the accuracy of PET-CT with regard to N staging is higher in patients who have undergone CRT than those who have not. PMID:21595776

Yen, T-J; Chung, C-S; Wu, Y-W; Yen, R-F; Cheng, M-F; Lee, J-M; Hsu, C-H; Chang, Y-L; Wang, H-P

2011-05-19

31

Diagnostic strategy for mucolipidosis II/III.  

PubMed

Overlapping clinical phenotypes are a diagnostic challenge to the clinician, especially in the cases of mucolipidosis (ML) and mucopolysaccharide disorders (MPS), due to overlapping phenotypes. Present study was carried out in 147 children suspected to have ML or MPS and 100 controls. They were screened for ML II/III by colorimetric method using substrate pNCS. Six children were found screen positive for ML II/III and further confirmatory study showed significantly raised activity in plasma confirming high specificity of the ML screening test. Forty-two (28.5%) children out of remaining 141 children that were screen negative, were found to have various MPS disorders, while rest 99 had normal enzyme activity in plasma and leucocytes. Present study demonstrates prompt and specific chemical method that can be used as a tool for estimating ML II/III, with high specificity. PMID:22728628

Sheth, J; Mistri, M; Kamate, M; Vaja, S; Sheth, F J

2012-06-10

32

Transcriptional profiling suggests that Barrett's metaplasia is an early intermediate stage in esophageal adenocarcinogenesis.  

PubMed

To investigate the relationship between Barrett's esophagus (BE) and esophageal adenocarcinoma (EAC), we determined gene expression profiles of discrete pathological stages of esophageal neoplasia using a sequence-verified human cDNA microarray. Fifty one RNAs, comprising 24 normal esophagi (NE), 18 BEs, and nine EACs were hybridized to cDNA microarrays. Five statistical analyses were used for the data analysis. Genes showing significantly different expression levels among the three sample groups were identified. Genes were grouped into functional categories based on the Gene Ontology Consortium. Surprisingly, the expression pattern of BE was significantly more similar to EAC than to NE, notwithstanding the known histopathologic differences between BE and EAC. The pattern of NE was clearly distinct from that of EAC. Thirty-six genes were the most differentially modulated, according to these microarray data, in BE-associated neoplastic progression. Twelve genes were significantly differentially expressed in cancer-associated BE's plus EAC (as a single combined tissue group) vs noncancer-associated BE's. These genes represent potential biomarkers to diagnose EAC at its early stages. Our results demonstrate that molecular events at the transcriptional level in BE are remarkably similar to BE's-associated adenocarcinoma of the esophagus. This finding alarmingly implies that BE is biologically closer to cancer than to normal esophagus, and that the cancer risk of BE is perhaps higher than we had imagined. These findings suggest that changes modulated at the molecular biologic level supervene earlier than histologic changes, and that BE is an early intermediate stage in the process of EAC. PMID:16449976

Wang, S; Zhan, M; Yin, J; Abraham, J M; Mori, Y; Sato, F; Xu, Y; Olaru, A; Berki, A T; Li, H; Schulmann, K; Kan, T; Hamilton, J P; Paun, B; Yu, M M; Jin, Z; Cheng, Y; Ito, T; Mantzur, C; Greenwald, B D; Meltzer, S J

2006-01-30

33

Role of F18-FDG PET/CT in the Staging and Restaging of Esophageal Cancer: A Comparison with CECT.  

PubMed

Esophageal cancer is one of the most fatal cancers principally because of its late presentation. CECT plays an important role in the staging of esophageal cancer but has some limitations. PET/CT which provides physiological information along with anatomical information and is a whole body imaging technique may therefore be a better alternative and thereby can facilitate selection or exclusion of patients for resection. The aim was to evaluate the performance of F18 FDG PET/CT in the staging and restaging of esophageal carcinoma compared to CECT using histopathologic findings and clinical follow-up as gold standard. Twenty eight patients with proven esophageal carcinoma, both preoperative and postoperative, were studied with CECT and F18 FDG PET/CT scan within an interval of 2 weeks. The PET/CT scan was acquired after injection of 370 MBq (10 mCi) F18-FDG and was evaluated for areas of increased focal uptake. CECT scan of chest and abdomen was done after injection of iodinated non-ionic contrast media. CECT findings suggested stage-IV disease in 16/28 (57.14%) patients and non stage-IV disease in 12/28 (42.86%) patients, whereas PET/CT suggested stage-IV disease in 23/28 (82.14%) patients and non stage-IV disease in 5/28 (17.86%) patients. Total nine patients were upstaged by PET/CT compared to CECT, out of which 7 (25%) were correctly upstaged and 2 (7.14%) were falsely upstaged. PET/CT improved our ability to detect distant metastases in 25% of patients that was missed by CECT. So, the use of F18 FDG PET/CT in esophageal cancer can alter management in significant number of patients. PMID:23204793

Kumar, Praveen; Damle, Nishikant A; Bal, Chandrasekhar

2012-02-18

34

Prognosis of esophageal cancers preoperatively staged to be locally invasive (T4) by endoscopic ultrasound (EUS): a multicenter retrospective cohort study  

Microsoft Academic Search

Background: Endosonography is a significant advance in the preoperative staging (TNM classification) of esophageal cancer. Its accuracy for evaluating depth of tumor invasion is over 80%.Methods: A multicenter retrospective cohort study of patients with esophageal carcinomas defined to be invasive (T4) by endosonography was performed to compare the survival of surgically and nonsurgically treated patients. Median survival time, overall mortality,

Amitabh Chak; Mimi Canto; Hans Gerdes; Charles J. Lightdale; Robert H. Hawes; Maurits J. Wiersema; George Kallimanis; T. Lok Tio; Thomas W. Rice; H. Worth Boyce; Michael V. Sivak

1995-01-01

35

Esophageal cancer  

SciTech Connect

This book contains the proceedings on esophageal cancer. Topics covered include: Scope of the problem, Diagnostic considerations: Methods of early diagnosis, Staging criteria, Elective surgical management, and Postoperative complications.

Delarue, N.C. (Univ. of Toronto, Toronto (CA)); Wilkins, E.W. Jr. (Harvard Medical School, MA (US)); Wong, J. (Dept. of Surgery, Univ. of Hong Kong (HK))

1988-01-01

36

Image-Guided Hypofractionated Radiation Therapy With Stereotactic Body Radiation Therapy Boost and Combination Chemotherapy in Treating Patients With Stage II-III Non-Small Cell Lung Cancer That Cannot Be Removed By Surgery  

ClinicalTrials.gov

Adenocarcinoma of the Lung; Adenosquamous Cell Lung Cancer; Large Cell Lung Cancer; Recurrent Non-small Cell Lung Cancer; Squamous Cell Lung Cancer; Stage IIA Non-small Cell Lung Cancer; Stage IIB Non-small Cell Lung Cancer; Stage IIIA Non-small Cell Lung Cancer; Stage IIIB Non-small Cell Lung Cancer

2013-08-22

37

Impact of PET-CT on Primary Staging and Response Control on Multimodal Treatment of Esophageal Cancer  

Microsoft Academic Search

Background  The predictive value of positron emission tomography-computed tomography (PET-CT) in primary staging and response control\\u000a in patients with esophageal carcinoma (EC) is under discussion. In the present study initial staging and metabolic response\\u000a of PET-CT was correlated with tumor regression and survival in patients with multimodal treatment of EC.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  The authors conducted a retrospective analysis on a prospective database for

Kirsten Thurau; Daniel Palmes; Christiane Franzius; Evgeny Minin; Norbert Senninger; Kai Uwe Juergens; Matthias Bruewer

2011-01-01

38

Results of chemoradiotherapy for stage I esophageal cancer in medically inoperable patients compared with results in operable patients.  

PubMed

The purpose of the present study was to evaluate long-term results of chemoradiotherapy for clinical T1b-2N0M0 esophageal cancer and to compare outcomes for operable and inoperable patients. Patients with stage I esophageal cancer (Union for International Cancer Control [UICC] 2009), excluding patients with cT1a esophageal cancer, were studied. All patients had histologically proven squamous cell carcinoma. Operable patients received cisplatin and 5-fluorouracil with concurrent radiotherapy of 60 Gy including a 2-week break. Inoperable patients received nedaplatin and 5-fluorouracil with concurrent radiotherapy of 60-70 Gy without a pause. End-points were overall survival rate (OS), cause-specific survival rate (CSS), progression-free survival rate (PFS), and locoregional control rate (LC). Thirty-seven operable patients and 30 medically inoperable patients were enrolled. There was a significant difference in only age between the operable group and inoperable group (P = 0.04). The median observation period was 67.9 months. In all patients, 5-year OS, CSS, PFS, and LC were 77.9%, 91.5%, 66.9%, and 80.8%, respectively. Comparison of the operable group and inoperable group showed that there was a significant difference in OS (5-year, 85.5% vs. 68.7%, P = 0.04), but there was no difference in CSS, PFS, or LC. Grade 3 or more late toxicity according to Common Terminology Criteria for Adverse Events v 3.0 was found in seven patients. Even in medically inoperable patients with stage I esophageal cancer, LC of more than 80% can be achieved with chemoradiotherapy. However, OS in medically inoperable patients is significantly worse than that in operable patients. PMID:22925398

Jingu, K; Matsushita, H; Takeda, K; Narazaki, K; Ariga, H; Umezawa, R; Sugawara, T; Miyata, G; Onodera, K; Nemoto, K; Yamada, S

2012-08-23

39

Esophageal atresia associated with anorectal malformation: Is the outcome better after surgery in two stages in a limited resources scenario?  

PubMed Central

Aims: To analyze whether outcome of neonates having esophageal atresia with or without tracheoesophageal fistula (EA±TEF) associated with anorectal malformation (ARM) can be improved by doing surgery in 2 stages. Materials and Methods: A prospective study of neonates having both EA±TEF and ARM from 2004 to 2011. The patients with favorable parameters were operated in a single stage, whereas others underwent first-stage decompression surgery for ARM. Thereafter, once septicemia was under control and ventilator care available, second-stage surgery for EA±TEF was performed. Results: Total 70 neonates (single stage = 20, 2 stages = 30, expired after colostomy = 9, only EA±TEF repair needed = 11) were enrolled. The admission rate for this association was 1 per 290. Forty-one percent (24/70) neonates had VACTERL association and 8.6% (6/70) neonates had multiple gastrointestinal atresias. Sepsis screen was positive in 71.4% (50/70). The survival was 45% (9/20) in neonates operated in a single stage and 53.3% (16/30) when operated in 2 stages (P = 0.04). Data analysis of 50 patients revealed that the survived neonates had significantly better birth weight, better gestational age, negative sepsis screen, no cardiac diseases, no pneumonia, and 2-stage surgery (P value 0.002, 0.003, 0.02, 0.02, 0.04, and 0.04, respectively). The day of presentation and abdominal distension had no significant effect (P value 0.06 and 0.06, respectively). This was further supported by stepwise logistic regression analysis. Conclusions: In a limited resources scenario, the survival rate of babies with this association can be improved by treating ARM first and then for EA±TEF in second stage, once mechanical ventilator care became available and sepsis was under control.

Singh, Sunita; Wakhlu, Ashish; Pandey, Anand; Singh, Anita; Kureel, Shiv N.; Rawat, Jiledar; Srivastava, Payal Mishra

2012-01-01

40

Is there a role of whole-body bone scan in patients with esophageal squamous cell carcinoma  

PubMed Central

Background Correct detection of bone metastases in patients with esophageal squamous cell carcinoma is pivotal for prognosis and selection of an appropriate treatment regimen. Whole-body bone scan for staging is not routinely recommended in patients with esophageal squamous cell carcinoma. The aim of this study was to investigate the role of bone scan in detecting bone metastases in patients with esophageal squamous cell carcinoma. Methods We retrospectively evaluated the radiographic and scintigraphic images of 360 esophageal squamous cell carcinoma patients between 1999 and 2008. Of these 360 patients, 288 patients received bone scan during pretreatment staging, and sensitivity, specificity, positive predictive value, and negative predictive value of bone scan were determined. Of these 360 patients, surgery was performed in 161 patients including 119 patients with preoperative bone scan and 42 patients without preoperative bone scan. Among these 161 patients receiving surgery, 133 patients had stages II?+?III disease, including 99 patients with preoperative bone scan and 34 patients without preoperative bone scan. Bone recurrence-free survival and overall survival were compared in all 161 patients and 133 stages II?+?III patients, respectively. Results The diagnostic performance for bone metastasis was as follows: sensitivity, 80%; specificity, 90.1%; positive predictive value, 43.5%; and negative predictive value, 97.9%. In all 161 patients receiving surgery, absence of preoperative bone scan was significantly associated with inferior bone recurrence-free survival (P?=?0.009, univariately). In multivariate comparison, absence of preoperative bone scan (P?=?0.012, odds ratio: 5.053) represented the independent adverse prognosticator for bone recurrence-free survival. In 133 stages II?+?III patients receiving surgery, absence of preoperative bone scan was significantly associated with inferior bone recurrence-free survival (P?=?0.003, univariately) and overall survival (P?=?0.037, univariately). In multivariate comparison, absence of preoperative bone scan was independently associated with inferior bone recurrence-free survival (P?=?0.009, odds ratio: 5.832) and overall survival (P?=?0.029, odds ratio: 1.603). Conclusions Absence of preoperative bone scan was significantly associated with inferior bone recurrence-free survival, suggesting that whole-body bone scan should be performed before esophagectomy in patients with esophageal squamous cell carcinoma, especially in patients with advanced stages.

2012-01-01

41

Multidisciplinary management of esophageal cancer.  

PubMed

This article reviews the current management of esophageal cancer, including staging and treatment options, as well as providing support for using multidisciplinary teams to better manage esophageal cancer patients. PMID:23453332

Mulligan, Charles R

2013-01-30

42

Feasibility of endoscopic mucosal resection as salvage treatment for patients with local failure after definitive chemoradiotherapy for stage IB, II, and III esophageal squamous cell cancer.  

PubMed

Local failure after definitive chemoradiotherapy (CRT) for stage IB, II, and III esophageal cancer is one of the causes of poor outcome. Endoscopic mucosal resection (EMR) is an effective treatment for superficial esophageal cancer. However, its feasibility as a salvage treatment for local recurrent or residual tumors after definitive CRT for stage IB, II, and III esophageal cancer remains unclear. Between January 2000 and February 2008, 274 patients with stage IB, II, and III esophageal squamous cell cancer excluding T4 received definitive CRT at the National Cancer Center Hospital, Japan. Of these patients, nine patients with local recurrence after achieving complete response and two patients with residual tumor underwent salvage EMR. The technique of salvage EMR involved a strip biopsy method. We retrospectively reviewed the 11 patients (13 lesions). Characteristics of all 11 patients were as follows: median age of 69 (range: 45-78); male/female: 10/1; baseline clinical stage (Union for International Cancer Control 7th) IB/IIA/IIB/III: 1/3/7/0. The depth of resected tumor was limited to the mucosal layer in seven lesions and submucosal in six lesions. En bloc resection was performed on six lesions (46%). The vertical margin was free of cancer cells in 11 lesions (84.6%). No major complications, such as hemorrhage requiring blood transfusion and perforation, were experienced. At a median follow-up period of 38.9 months (range: 5.3-94 months) after salvage EMR, no recurrence was detected in six patients (54%). Local recurrence was detected in five patients (27%). Of these patients, two had lung metastasis simultaneously, and one was also detected lung metastasis 2 months after the detection of local recurrence. The 5-year survival rate after salvage EMR was 41.6%. Salvage EMR is a feasible treatment option for local recurrent or residual lesions after definitive chemotherapy and/or radiotherapy for stage IB, II, and III esophageal squamous cell cancer. PMID:23442160

Makazu, M; Kato, K; Takisawa, H; Yoshinaga, S; Oda, I; Saito, Y; Mayahara, H; Ito, Y; Itami, J; Hamaguchi, T; Yamada, Y; Shimada, Y

2013-02-26

43

Acute Radiation Esophagitis Caused by High-dose Involved Field Radiotherapy with Concurrent Cisplatin and Vinorelbine for Stage III Non-small Cell Lung Cancer.  

PubMed

Purpose of this study is to obtain dose-volume histogram (DVH) predictors and threshold values for radiation esophagitis caused by high-dose involved field radiotherapy (IFRT) with concurrent chemotherapy in patients with stage III non-small cell lung cancer (NSCLC). Thirty-two patients treated by 66?Gy/33?Fr, 72?Gy/36?Fr, and 78?Gy/39?Fr thoracic radiotherapy without elective nodal irradiation plus concurrent cisplatin and vinorelvine were reviewed. Acute radiation esophagitis was evaluated according to common terminology criteria for adverse events version 4.0, and correlations between grade 2 or worse radiation esophagitis and DVH parameters were investigated. Grade 0-1, 2, 3, and 4-5 of radiation esophagitis were seen in 11 (34.4%), 20 (62.5%), 1 (3.1%), and 0 (0%) of the patients, respectively. Multivariate analysis revealed that whole esophagus V35 is a predictor of radiation esophagitis (OR =?0.74 [95%CI; 0.60-0.91], p =?0.006). There is a significant difference (38.4% vs. 89.4%, p =?0.027) in the cumulative rates of acute esophagitis according to V35 values of more than 20% versus less. As compared with other factors concerning patient and tumor and treatment factors, V35 ? 20% of the esophagus was an independent predictor (HR?5?0.29 [95%CI; 0.09-0.85], p?5?0.025). In conclusion, whole esophagus V35 < 20% is proposed in high-dose IFRT with concurrent chemotherapy for stage III NSCLC patients. PMID:23369154

Kuroda, Y; Sekine, I; Sumi, M; Sekii, S; Takahashi, K; Inaba, K; Horinouchi, H; Nokihara, H; Yamamoto, N; Kubota, K; Murakami, N; Morota, M; Mayahara, H; Ito, Y; Tamura, T; Nemoto, K; Itami, J

2013-01-25

44

Capecitabine and Cisplatin Chemotherapy (XP) Alone or Sequentially Combined Chemoradiotherapy Containing XP Regimen in Patients with Three Different Settings of Stage IV Esophageal Cancer  

Microsoft Academic Search

Background: The 1997 staging system for esophageal carcinoma subdivided distant metastatic disease (M1) into nonregional lymph node metastases (M1a) and other metastases (M1b). To determine the relevance of this classification system, we investigated the efficacy and toxicity of capecitabine\\/cisplatin (XP) chemotherapy alone or in combination with radiotherapy. Methods: We identif ied 74 patients with M1 disease treated at Asan Medical

Sung Sook Lee; Sung-Bae Kim; Seung-Il Park; Yong Hee Kim; Jin-Sook Ryu; Ho-Yong Song; Ji Hoon Shin; Hwoon Yong; Gin Jung; Hyug Lee; Kee Don Choi; Kyung-Ja Cho; Jong Hoon Kim

45

Does the Value of PET-CT Extend Beyond Pretreatment Staging? An Analysis of Survival in Surgical Patients with Esophageal Cancer  

Microsoft Academic Search

Background  Studies of positron emission tomography (PET) have focused mainly on tumor staging. The role of PET in predicting survival\\u000a has received less attention. We sought to assess the relationship of pretreatment maximum standard uptake value (SUVmax) to survival in surgical patients with esophageal cancer.\\u000a \\u000a \\u000a \\u000a Methods  The study consisted of 72 esophagectomy patients (60 with adenocarcinoma) undergoing resection between July 2005 and

Boris Sepesi; Daniel P. Raymond; Marek Polomsky; Thomas J. Watson; Virginia R. Litle; Carolyn E. Jones; Rui Hu; Xing Qiu; Jeffrey H. Peters

2009-01-01

46

Hypermethylation of the nel-like 1 gene is a common and early event and is associated with poor prognosis in early-stage esophageal adenocarcinoma.  

PubMed

The nel-like1 (NELL1) gene maps to chromosome 11p15, which frequently undergoes loss of heterozygosity in esophageal adenocarcinoma (EAC). NELL1 promoter hypermethylation was examined by real-time methylation-specific polymerase chain reaction in 259 human esophageal tissues. Hypermethylation of this promoter showed highly discriminative receiver-operator characteristic curve profiles, clearly distinguishing esophageal squamous cell carcinoma (ESCC) and EAC from normal esophagus (NE) (P<0.001). NELL1 normalized methylation values were significantly higher in Barrett's metaplasia (BE), dysplastic Barrett's (D) and EAC than in NE (P<0.0000001). NELL1 hypermethylation frequency was zero in NE but increased early during neoplastic progression, to 41.7% in BE from patients with Barrett's alone, 52.5% in D and 47.8% in EAC. There was a significant correlation between NELL1 hypermethylation and BE segment length. Three (11.5%) of 26 ESCCs exhibited NELL1 hypermethylation. Survival correlated inversely with NELL1 hypermethylation in patients with stages I-II (P=0.0264) but not in stages III-IV (P=0.68) EAC. Treatment of KYSE220 ESCC and BIC EAC cells with 5-aza-2'-deoxycytidine reduced NELL1 methylation and increased NELL1 mRNA expression. NELL1 mRNA levels in EACs with an unmethylated NELL1 promoter were significantly higher than those in EACs with a methylated promoter (P=0.02). Promoter hypermethylation of NELL1 is a common, tissue-specific event in human EAC, occurs early during Barrett's-associated esophageal neoplastic progression, and is a potential biomarker of poor prognosis in early-stage EAC. PMID:17452981

Jin, Z; Mori, Y; Yang, J; Sato, F; Ito, T; Cheng, Y; Paun, B; Hamilton, J P; Kan, T; Olaru, A; David, S; Agarwal, R; Abraham, J M; Beer, D; Montgomery, E; Meltzer, S J

2007-04-23

47

CITES I-II-III Timber Species Manual.  

National Technical Information Service (NTIS)

The CITES Appendixes I-II-III Timber Species Manual provides the procedures for the enforcement of the Convention on International Trade in Endangered Species of Wild Flora and Fauna (CITES) Appendix I, Appendix II, and Appendix III timber species. As def...

2006-01-01

48

Proposed Modification of Nodal Status in AJCC Esophageal Cancer Staging System  

Microsoft Academic Search

proportional-hazards analysis suggested that the location and number of involved lymph nodes were independent predictors of survival (p < 0.001). We propose a modified nodal staging system that designates celiac nodes as regional and includes number of involved nodes: pN0, no nodes (3 years 63%, n 496); pN1-regional, 1 to 3 nodes (3 years 32%, n 292); pN2-regional, more than

Wayne Hofstetter; Arlene M. Correa; Neby Bekele; Jaffer A. Ajani; Alexandria Phan; Ritsuko R. Komaki; Zhongxing Liao; Dipen Maru; Tsung T. Wu; Reza J. Mehran; David C. Rice; Jack A. Roth; Ara A. Vaporciyan; Garrett L. Walsh; Ashleigh Francis; Shanda Blackmon; Stephen G. Swisher

2010-01-01

49

[Esophageal tuberculosis].  

PubMed

Primary esophageal tuberculosis is virtually non-existent and there are few cases described of secondary esophageal tuberculosis. Esophageal tuberculosis should be suspected in patients with dysphagia, positive test results for tuberculin, active pulmonary disease or mediastinal adenopathies. Endoscopic or x-ray images could be indistinguishable from esophageal carcinomas, hence a diagnosis can prevent wrong treatments. Confirming the diagnosis requires isolation of tuberculosis bacillus. Treatment for a patient with esophageal tuberculosis is standard therapy. Key words: Tuberculosis, esophagus. PMID:16865167

Baños, Ramón; Serrano, Andrés; Alberca, Fernando; Alajarín, María; Albaladejo, Aquilino; Vargas, Angel; Molina, Joaquín

50

The Role of EUS in Esophageal Cancer  

Microsoft Academic Search

\\u000a Esophageal cancer is the fifth most common gastrointestinal cancer and the ninth leading cause of cancer death in the United\\u000a States. The incidence of esophageal adenocarcinoma is on the rise. Accurate staging of esophageal cancer is critical for the\\u000a selection of appropriate treatment. Endoscopic ultrasound (EUS) plays an important role in the staging of esophageal cancer.\\u000a EUS provides a detailed

Audrey H. Calderwood; Brian C. Jacobson

51

Multi-susceptibility genes associated with the risk of the development stages of esophageal squamous cell cancer in Feicheng County  

PubMed Central

Background The purpose of this study was to evaluate the association of multi-genotype polymorphisms with the stepwise progression of esophageal squamous cell cancer (ESCC) and the possibility of predicting those at higher risk. Methods A total of 1,004 subjects were recruited from Feicheng County, China, between Jan. 2004 and Dec. 2007 and examined by endoscopy for esophageal lesions. These subjects included 270 patients with basal cell hyperplasia (BCH), 262 patients with esophageal squamous cell dysplasia (ESCD), 226 patients with ESCC, and 246 controls with Lugol-voiding area but diagnosed as having normal esophageal squamous epithelial cells by histopathology. The genotypes for CYP2E1 G1259C, hOGG1 C326G, MTHFR C677T, MPO G463A, and ALDH2 allele genes were identified in blood samples collected from all participants. Results The alleles ALDH2 and MTHFR C677T were critical for determining individual susceptibility to esophageal cancer. Compared to the ALDH 1*1 genotype, the ALDH 2*2 genotype was significantly associated with increased risks of BCH, ESCD, and ESCC. However, the TT genotype of MTHFR C677T only increased the risk of ESCC. Further analysis revealed that the combination of the high-risk genotypes 2*2/1*2 of ALDH 2 and TT/TC of MTHFR C677T increased the risk of BCH by 4.0 fold, of ESCD by 3.7 fold, and ESSC by 8.72 fold. The generalized odds ratio (ORG) of the two combined genotypes was 1.83 (95%CI: 1.55-2.16), indicating a strong genetic association with the risk of carcinogenic progression in the esophagus. Conclusions The study demonstrated that the genotypes ALDH2*2 and MTHFR 677TT conferred elevated risk for developing esophageal carcinoma and that the two susceptibility genotypes combined to synergistically increase the risk.

2011-01-01

52

Multi-susceptibility genes associated with the risk of the development stages of esophageal squamous cell cancer in Feicheng County  

Microsoft Academic Search

Background  The purpose of this study was to evaluate the association of multi-genotype polymorphisms with the stepwise progression of\\u000a esophageal squamous cell cancer (ESCC) and the possibility of predicting those at higher risk.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  A total of 1,004 subjects were recruited from Feicheng County, China, between Jan. 2004 and Dec. 2007 and examined by endoscopy\\u000a for esophageal lesions. These subjects included 270

Qing Da Li; Hao Li; Mei Shu Wang; Tao Yu Diao; Zhi Ying Zhou; Qiang Xue Fang; Fang Yan Yang; Qing Hui Li

2011-01-01

53

Esophageal Cancer  

MedlinePLUS

... brachytherapy). Radiation therapy is most often combined with chemotherapy in people with esophageal cancer. It can be used before or after surgery. Radiation therapy is also used to relieve complications of advanced esophageal cancer, such as when a ...

54

A prospective evaluation of the impact of 18-F-fluoro-deoxy-D-glucose positron emission tomography staging on survival for patients with locally advanced esophageal cancer  

SciTech Connect

Purpose: To determine the impact of 18-F-fluoro-deoxy-D-glucose positron emission tomography (FDG-PET) in the staging and prognosis of patients with locally advanced esophageal cancer (LAEC). Methods and Materials: Between January 2000 and October 2004, all patients with LAEC evaluated in the Department of Radiation Oncology were considered for enrollment into a Phase II trial of preoperative chemoradiation. Entry required a staging whole-body FDG-PET scan. Results: One hundred ten consecutive patients were evaluated; 38 were ineligible for reasons including treatment elsewhere, prior malignancy, or refusal of treatment. After conventional staging (clinical examination, endoscopic ultrasound, and chest/abdominal computerized tomography), 33 patients were ineligible because of metastatic disease or poor performance status. Of the remaining 39 patients, 23 were confirmed to have LAEC after FDG-PET staging and were treated in the Phase II trial (Cohort I). Sixteen patients, however, had FDG-PET findings consistent with occult metastatic disease and were deemed ineligible for the trial but were treated with curative intent (Cohort II). The 2-year survival rate for the 23 patients in Cohort I was 64%, compared with 17% (p = 0.003) for patients in Cohort II (FDG-PET positive). Conclusions: More than one-third of patients determined to have LAEC with conventional staging were upstaged with the use of FDG-PET. Despite comparable therapy, upstaging with FDG-PET predicts poor 2-year survival.

Blackstock, A. William [Department of Radiation Oncology, Wake Forest University School of Medicine, Winston Salem, NC (United States)]. E-mail: ablackst@wfubmc.edu; Farmer, Michael R. [Department of Radiation Oncology, Wake Forest University School of Medicine, Winston Salem, NC (United States); Lovato, James [Department of Public Health Sciences, Wake Forest University School of Medicine, Winston Salem, NC (United States); Mishra, Girish [Division of Gastroenterology, Wake Forest University School of Medicine, Winston Salem, NC (United States); Melin, Susan A. [Division of Medical Oncology, Wake Forest University School of Medicine, Winston Salem, NC (United States); Oaks, Timothy [Department of Cardiothoracic Surgery, Wake Forest University School of Medicine, Winston Salem, NC (United States); Aklilu, Mabea [Division of Medical Oncology, Wake Forest University School of Medicine, Winston Salem, NC (United States); Clark, Paige B. [Division of Nuclear Medicine, Wake Forest University School of Medicine, Winston Salem, NC (United States); Levine, Edward A. [Department of Surgery, Wake Forest University School of Medicine, Winston Salem, NC (United States)

2006-02-01

55

Herpetic esophagitis  

SciTech Connect

Four patients with herpetic esophagitis were examined. In three of them, the presenting symptom was odynophagia. Early in the course of herpetic esophagitis, shallow round and oval ulcers were seen on barium esophagograms. Later, the ulcers filled with fibrinous exudate, forming nodular plaques that projected into the esophageal lumen. Although these findings are diagnostic of esophagitis, they are not specific for a herpes virus infection. The definitive diagnosis must be established by histologic examination, which demonstrates the cytopathic effect of the herpes virus infection within the squamous epithelium.

Shortsleeve, M.J.; Gauvin, G.P.; Gardner, R.C.; Greenberg, M.S.

1981-12-01

56

Pilot Trial of CRLX101 in Treatment of Patients With Advanced or Metastatic Stomach, Gastroesophageal, or Esophageal Cancer That Cannot be Removed by Surgery  

ClinicalTrials.gov

Adenocarcinoma of the Esophagus; Adenocarcinoma of the Gastroesophageal Junction; Diffuse Adenocarcinoma of the Stomach; Intestinal Adenocarcinoma of the Stomach; Mixed Adenocarcinoma of the Stomach; Recurrent Esophageal Cancer; Recurrent Gastric Cancer; Squamous Cell Carcinoma of the Esophagus; Stage IIIB Esophageal Cancer; Stage IIIB Gastric Cancer; Stage IIIC Esophageal Cancer; Stage IIIC Gastric Cancer; Stage IV Esophageal Cancer; Stage IV Gastric Cancer

2013-07-10

57

ESOPHAGEAL VARICES  

Microsoft Academic Search

Twelve patients with known esophageal varices and willingness to cooperate were included in the study. Medications administered were placebo, 2 mg of glucagon, and 30 mg of propantheline bromide. All medications were given double-blind and crossover. On the basis of this study the authors believe that for optimal visualization of esophageal varices the following is the procedure of choice: (I)

EDWARD M. COCKERILL; ROSCOE E. MILLER; STANLEY M. CHERNISH; GORDON C. McLAUGHLIN; BRUCE E. RODDA

58

Preoperative Cyfra21-1 and SCC-Ag serum titers predict survival in patients with stage II esophageal squamous cell carcinoma  

PubMed Central

Background The purpose of this study is to evaluate the predictive significance of preoperative serum level of cytokeratin 19 fragments (Cyfra21-1) and squamous cell carcinoma antigen (SCC-Ag) after complete resection in patients with stage II esophageal squamous cell carcinoma (ESCC). Methods Between 1995 and 2006, a total of 379 patients in stage II ESCC who underwent complete resection were consecutively recruited. Statistical analyses were applied to test the associations between preoperative serum titers of Cyfra21-1 and SCC-Ag, clinicopathological factors and prognoses. Results Preoperative high and normal serum level of Cyfra21-1 and SCC-Ag were found in 47.8%, 52.2% and 72.8%, 27.2%, respectively. The 1-, 3-, 5-year overall survival rate for the entire cohort of patients was 95%, 78%, and 56%, respectively. Median overall survival (OS) was 45.3 months longer in patients with low preoperative serum level of Cyfra21-1 (91.9 months) than those with high preoperative serum level of Cyfra21-1 (46.6 months) (P?stage IIB (P?stage, preoperative serum level of Cyfra21-1 and SCC-Ag were independently and significantly predictive factors (P?stage II ESCC.

2012-01-01

59

Hypermethylation of the nel-like 1 gene is a common and early event and is associated with poor prognosis in early-stage esophageal adenocarcinoma  

Microsoft Academic Search

The nel-like1 (NELL1) gene maps to chromosome 11p15, which frequently undergoes loss of heterozygosity in esophageal adenocarcinoma (EAC). NELL1 promoter hypermethylation was examined by real-time methylation-specific polymerase chain reaction in 259 human esophageal tissues. Hypermethylation of this promoter showed highly discriminative receiver–operator characteristic curve profiles, clearly distinguishing esophageal squamous cell carcinoma (ESCC) and EAC from normal esophagus (NE) (P<0.001). NELL1

Z Jin; Y Mori; J Yang; F Sato; T Ito; Y Cheng; B Paun; J P Hamilton; T Kan; A Olaru; S David; R Agarwal; J M Abraham; D Beer; E Montgomery; S J Meltzer

2007-01-01

60

Caustic ingestion and esophageal function  

SciTech Connect

The aim of the present study was to investigate esophageal motor function by means of krypton-81m esophageal transit scintigraphy and to compare the results with the functional and morphological data obtained by means of triple lumen manometry and endoscopy. In acute and subacute stages of the disease, all clinical, anatomical, and functional parameters were in good agreement, revealing significant impairment. In chronic stages, the severity of the dysphagia was not correlated to the importance of the residual stenosis. Conversely, 81mKr esophageal transit and manometric's findings were in good agreement with the clinical symptoms, during the entire follow-up period ranging between 3 months to 7 years. The 81mKr test is undoubtedly the easiest and probably the most physiological technique currently available for long-term functional evaluation of caustic esophagitis.

Cadranel, S.; Di Lorenzo, C.; Rodesch, P.; Piepsz, A.; Ham, H.R. (Children University Hospital, Brussels (Belgium))

1990-02-01

61

Epidemiology of esophageal cancer  

PubMed Central

Esophageal cancer (EsC) is one of the least studied and deadliest cancers worldwide because of its extremely aggressive nature and poor survival rate. It ranks sixth among all cancers in mortality. In retrospective studies of EsC, smoking, hot tea drinking, red meat consumption, poor oral health, low intake of fresh fruit and vegetables, and low socioeconomic status have been associated with a higher risk of esophageal squamous cell carcinoma. Barrett’s esophagus is clearly recognized as a risk factor for EsC, and dysplasia remains the only factor useful for identifying patients at increased risk, for the development of esophageal adenocarcinoma in clinical practice. Here, we investigated the epidemiologic patterns and causes of EsC. Using population based cancer data from the Surveillance, Epidemiology and End Results Program of the United States; we generated the most up-to-date stage distribution and 5-year relative survival by stage at diagnosis for 1998-2009. Special note should be given to the fact that esophageal cancer, mainly adenocarcinoma, is one of the very few cancers that is contributing to increasing death rates (20%) among males in the United States. To further explore the mechanism of development of EsC will hopefully decrease the incidence of EsC and improve outcomes.

Zhang, Yuwei

2013-01-01

62

Esophageal Cancer  

MedlinePLUS

... the abdomen and connects the mouth to the stomach. Cancer, or a malignant tumor, is the result of ... stomach join should be considered esophageal cancer or stomach cancer. Interestingly, it's this region which gives rise to ...

63

Eosinophilic Esophagitis  

Microsoft Academic Search

Eosinophilic esophagitis is a chronic inflammatory disorder characterized by dense eosinophilic infiltration of the esophageal\\u000a mucosa. The pathogenesis is incompletely understood and food allergies and aeroallergens have been implicated. The most common\\u000a clinical presentation in adults is dysphagia to solids. Its associated endoscopic findings are distinct and include concentric\\u000a rings and longitudinal furrows, although endoscopy may be unremarkable in a

Fouad J. Moawad; Ganesh R. Veerappan; Roy K. Wong

2009-01-01

64

[Esophageal injuries].  

PubMed

Despite progress in the management of esophageal perforations by early diagnosis, antibiotics, monitoring, and respiratory and nutritional support, it still remains as a disasterous condition. The most common cause of esophageal perforation is iatrogenic disruption. The result in the management of esophageal perforation is influenced by several factors: localization and size of the rupture, length of delay in diagnosis, age, extent of mediastinal and pleural contamination, the presence of underlying esophageal diseases, and inflammation or tumor at the perforation localization. In this study, 7 cases of esophageal perforations in the last six years have been analysed retrospectively. In study group, there were 5 males and 2 females, and the mean age was 36 (12-75). The most common cause of perforation was gunshot injury (3 cases), and stab wound (1 case), foreign body (1 case), iatrogenic distruption (2 cases). Three patients died and four patients were discharged from hospital with recovery. Esophageal perforation is a life-threatening condition. Early diagnosis and repair reduces the morbidity and mortality. PMID:11705168

Ertekin, C; Yanar, H T; Gülo?lu, R; Tavilo?lu, K; Dilege, S

2001-01-01

65

Pralatrexate and Oxaliplatin in Treating Patients With Unresectable or Metastatic Esophageal, Stomach, or Gastroesophageal Junction Cancer  

ClinicalTrials.gov

Adenocarcinoma of the Esophagus; Adenocarcinoma of the Gastroesophageal Junction; Diffuse Adenocarcinoma of the Stomach; Intestinal Adenocarcinoma of the Stomach; Mixed Adenocarcinoma of the Stomach; Recurrent Esophageal Cancer; Recurrent Gastric Cancer; Squamous Cell Carcinoma of the Esophagus; Stage III Esophageal Cancer; Stage III Gastric Cancer; Stage IV Esophageal Cancer; Stage IV Gastric Cancer

2013-09-12

66

[A case of a patient with stage IVa esophageal cancer surviving over 4 years by combination chemotherapy with docetaxel,5 -FU and cisplatin, without operation].  

PubMed

A male patient in his 50s was found to have lower thoracic advanced esophageal squamous cell carcinoma by upper gastrointestinal endoscopy with the chief complaint of dysphagia in July 2006. CT revealed supraclavicular lymph node metastasis, and he was diagnosed as clinical stage IVa. He underwent two courses of combination chemotherapy with docetaxel, 5-FU and cisplatin(DFP therapy: docetaxel at 25mg/m / / 2 on day 1, 5-FU at 370 mg/m2 on days 1-5, and cisplatin at 7 mg/m2 on days 1-5 were repeated weekly for 4 weeks). The primary tumor disappeared and the lymph node was reduced as observed by upper gastrointestinal endoscopy and CT. After 2 courses of DFP therapy, PET-CT revealed that the primary tumor and lymph node had no new accumulation. Because he refused both operation and chemoradiotherapy, the patient underwent oral chemotherapy. In January 2010, PET-CT and upper gastrointestinal endoscopy revealed that the primary tumor relapsed. DFP therapy was performed and was effective once again. He has survived for over 4 years and 4 months without operation. PMID:21829072

Yamamoto, Yota; Ikeda, Mayumi; Takashima, Mika; Minato, Takuya; Furukita, Yoshihito; Takechi, Hirokazu; Seike, Junichi; Tangoku, Akira

2011-08-01

67

[Esophageal cancer].  

PubMed

Esophageal cancers are highly malignant tumours with often a poor prognostic, except for minimal lesions treated with surgery. Radiation therapy, or combined radiation and chemotherapy is the most used therapeutic modality, alone or before oesophagectomy. The delineation of target volumes is now more accurate owing the possibility to use routinely the new imaging techniques (mainly PET). The aim of this work is to precise the radio-anatomical particularities, the pattern of spread of esophageal cancer and the principles of 3D conformal radiotherapy illustrated with a clinical case. PMID:21129673

Dupuis, O; Ganem, G; Béra, G; Pointreau, Y; Pradier, O; Martin, P; Mirabel, X; Denis, F

2010-11-01

68

Eosinophilic esophagitis.  

PubMed

Eosinophilic esophagitis is a chronic inflammatory disorder characterized by dense eosinophilic infiltration of the esophageal mucosa. The pathogenesis is incompletely understood and food allergies and aeroallergens have been implicated. The most common clinical presentation in adults is dysphagia to solids. Its associated endoscopic findings are distinct and include concentric rings and longitudinal furrows, although endoscopy may be unremarkable in a minority of patients. A number of management strategies exist; however, data are limited in adults, and only a few are based on randomized controlled trials. Management options include dietary modifications, pharmacological therapy, and endoscopic dilation. PMID:19554448

Moawad, Fouad J; Veerappan, Ganesh R; Wong, Roy K

2009-06-25

69

Esophageal functional impairments in experimental eosinophilic esophagitis  

PubMed Central

Eosinophilic esophagitis (EoE) is an emerging chronic esophageal disease. Despite the increasing diagnosis of EoE globally, the causes of EoE and other esophageal eosinophilic disorders are not clearly understood. EoE pathology includes accumulation of inflammatory cells (e.g., eosinophils, mast cells), characteristic endoscopic features (e.g., furrows, the formation of fine concentric mucosal rings, exudates), and functional impairments (e.g., esophageal stricture, dysmotility). We hypothesized that the esophageal structural pathology and functional impairments of EoE develop as a consequence of the effector functions of the accumulated inflammatory cells. We analyzed eosinophils (anti-major basic protein immunostaining), esophageal stricture (X-ray barium swallowing), and esophageal motility (isometric force) in two established transgenic murine models of EoE (CD2-IL-5 and rtTA-CC10-IL-13) and a novel eosinophil-deficient model (?dblGATA/CD2-IL-5). Herein, we show the following: 1) CD2-IL-5 and doxycycline (DOX)-induced rtTA-CC10-IL-13 mice have chronic eosinophilic and mast cell esophageal inflammation; 2) eosinophilic esophageal inflammation promotes esophageal stricture in both transgenic murine models; 3) the eosinophil-deficient ?dblGATA/CD-2-IL-5 mice were protected from the induction of stricture, whereas the eosinophil-competent CD2-IL-5 mice develop esophageal stricture; 4) esophageal stricture is not reversible in DOX-induced rtTA-CC10-IL-13 mice (8 wk DOX followed by 8 wk no-DOX); and 5) IL-5 transgene-induced (CD2-IL-5) EoE evidences esophageal dysmotility (relaxation and contraction) that is independent of the eosinophilic esophageal inflammation: CD2-IL-5 and ?dblGATA/CD2-IL-5 mice have comparable esophageal dysmotility. Collectively, our present study directly implicates chronic eosinophilic inflammation in the development of the esophageal structural impairments of experimental EoE.

Mavi, Parm; Rajavelu, Priya; Rayapudi, Madhavi; Paul, Richard J.

2012-01-01

70

Titan 34D\\/IUS\\/DSCS II-III launch  

Microsoft Academic Search

A description is given of a mission in which two Defense Satellite Communication System spacecraft (DSCS-II and DSCS-III) were placed into a near-synchronous equatorial orbit with the aid of the Inertial Upper Stage (IUS) and the Titan 34D launch vehicle. Liftoff of the T34D\\/IUS-2 launch vehicle occurred on October 30, 1982. Attention is given to details regarding the design and

D. J. Rohrbaugh; C. Ufferheide

1984-01-01

71

Esophageal cancer characterization with pneumo-64-MDCT.  

PubMed

Early diagnosis and accurate staging of esophageal cancer are both essential for therapeutic strategy planning. Endoscopic ultrasound, CT, and positron emission tomography have all been used in the preoperative staging of esophageal cancer separately or in various combinations. Each imaging method has its strengths and weaknesses. Depiction of the tumor's anatomic location conditions the surgical strategy. Endoscopic ultrasound and PET have important advantages but neither provides information for surgical planning. CT scans have some limitations for hollow organ assessment in the absence of lumen distension, since the organ wall may be collapsed. Therefore, optimal esophageal distension could be very useful to overcome these limitations. This potential drawback is crucial at the level of the GE junction, a typically difficult region to evaluate. In order to optimize tumor visualization in the esophageal wall and in the GE junction, we developed a technique named pneumo-64-MDCT. We achieve maximum lumen distension, which better highlights the thickened areas in relation to the normal esophageal wall. At the present time, we have performed 200 studies with this technique and it proved useful, safe and accurate to identify esophageal wall thickening and to stage esophageal cancer. The additional stomach distension led to an adequate definition of both the upper and lower borders of the lesion in tumors located in the GE junction, which in turn was helpful to design the surgical approach. PMID:21842399

Ulla, Marina; Gentile, Ernestina María José; Cavadas, Demetrio; Yeyati, Ezequiel Levy; Frank, Laura; Argerich, Javier Ithurralde; Garcia Mónaco, Ricardo

2012-08-01

72

CHEMICAL INTERACTIONS OF ARSENATE, ARSENITE, PHOSPHATE, AND SILICATE WITH IRON (II,III) HYDROXYCARBONATE GREEN RUST  

EPA Science Inventory

Granular zerovalent iron has been proposed to be used as a medium in permeable reactive barriers (PRBs) to remove arsenic from contaminated groundwater. Iron(II, III) hydroxycarbonate green rust (carbonate green rust, or CGR) is a major corrosion product of zerovalent iron under ...

73

CHEMICAL INTERACTIONS OF ARSENATE, ARSENITE, PHOSPHATE, AND SILICATE WITH IRON (II, III) HYDROXYCARBONATE GREEN RUST  

EPA Science Inventory

Granular zerovalent iron has been proposed to be used as a medium in permeable reactive barriers (PRBs) to remove arsenic from contaminated groundwater. Iron(II, III) hydroxycarbonate green rust (carbonate green rust, or CGR) is a major corrosion product of zerovalent iron under ...

74

LAAS Ground Facility Design Improvements to Meet Proposed Requirements for Category II\\/III Operations  

Microsoft Academic Search

Stanford University has developed a Local Area Augmentation System (LAAS) ground facility prototype known as the Integrity Monitor Testbed (IMT) to demonstrate the feasibility of LAAS precision approaches under Category I conditions. While the Category I IMT is essentially complete, research on IMT algorithms continues to improve its performance so that it can eventually meet Category II\\/III approach requirements. To

Sam Pullen; Ming Luo; Gang Xie; Jiyun Lee; R. Eric Phelts; Dennis Akos; Per Enge

75

A hybridized displacement discontinuity method for mixed mode I–II–III loading  

Microsoft Academic Search

A new hybridized displacement discontinuity numerical method is presented. The existing code FROCK is modified to incorporate loading mode III, and thus have a fully coupled solution for mixed mode I–II–III loading. The new code can be applied to homogeneous elastic bodies with small scale yielding and to cracks where one of the dimensions is much larger than the other

A. Bobet

2001-01-01

76

Titan 34D/IUS/DSCS II-III launch  

NASA Astrophysics Data System (ADS)

A description is given of a mission in which two Defense Satellite Communication System spacecraft (DSCS-II and DSCS-III) were placed into a near-synchronous equatorial orbit with the aid of the Inertial Upper Stage (IUS) and the Titan 34D launch vehicle. Liftoff of the T34D/IUS-2 launch vehicle occurred on October 30, 1982. Attention is given to details regarding the design and the objectives of the IUS, the prelaunch activities, the mission plan, a mission event description, details of IUS spacecraft placement performance, a summary of problems during countdown, and mission anomalies.

Rohrbaugh, D. J.; Ufferheide, C.

1984-10-01

77

Esophageal Cancer  

Microsoft Academic Search

\\u000a Purpose:  To present the results of a prospective phase II study in esophageal carcinoma.\\u000a \\u000a \\u000a \\u000a Patients and Methods:  Patients received single doses of 1.8 Gy up to 27 Gy, then concomitant boost to a total of 50.4 Gy (PTV2 [planning target\\u000a volume], single dose 1.8 Gy) and 64.8 Gy (PTV1, single dose 1.2 Gy in the morning and 1.8 Gy in the afternoon)

Thomas B. Brunner; Andreas Rupp; Winfrid Melzner; Gerhard G. Grabenbauer; Rolf Sauer

2008-01-01

78

Aging and Surveillance Program Minuteman II/III Stage 2 Program Progress.  

National Technical Information Service (NTIS)

Statistically significant correlations, relationships and trends have been developed throughout the aging program which can be applied to service life assessment. Measurement of moisture within sealed rocket motors indicates that moisture equilibrium in t...

1987-01-01

79

Systematic design of CCI(II)(III)s by combining UGCs  

Microsoft Academic Search

The systematic design of the first generation (CCI), second generation (CCII), and third generation (CCIII) current conveyor is presented by combining three kinds of unity-gain cells (UGCs), namely: the voltage follower (VF), the current follower (CF) and the current mirror (CM). Furthermore, it is highlighted that the CCI(II)(III) can be designed by evolving a VF biased with ideal current sources,

E. Tlelo-Cuautle; D. Moro-Frias; M. Fakhfakh

2008-01-01

80

Current Gene Expression Studies in Esophageal Carcinoma  

PubMed Central

Esophageal carcinoma is one of the deadliest cancers with highly aggressive potency, ranking as the sixth most common cancer among males and ninth most common cancer among females globally. Due to metastasis and invasion of surrounding tissues in early stage, the 5-year overall survival rate (14%) of esophageal cancer remains poor, even in comparison with the dismal survival rates (4%) from the 1970s. Numerous genes and proteins with abnormal expression and function involve in the pathogenesis of esophageal cancer, but the concrete process remains unclear. Microarray technique has been applied to investigating esophageal cancer. Many gene expression studies have been undertaken to look at the specific patterns of gene transcript levels in esophageal cancer. Human tissues and cell lines were used in these geneprofiling studies and a very valuable and interesting set of data has resulted from various microarray experiments. These expression studies have provided increased understanding of the complex pathological mechanisms involved in esophageal cancer. The eventual goal of microarray is to discover new markers for therapy and to customize therapy based on an individual tumor genetic composition. This review summarized the current state of gene expression profile studies in esophageal cancer.

Guo, Wei; Jiang, Yao-Guang

2009-01-01

81

Carcinoma of esophagus: radiologic diagnosis and staging.  

PubMed

Esophageal carcinoma is an uncommon malignancy accounting for approximately 7% of gastrointestinal tract cancers and 1% of all cancers. Esophageal cancer still remains one of the most lethal of all cancers. Since a multimodality approach is presently used to treat esophageal cancer, early radiologic diagnosis and accurate tumor staging are essential to direct therapy toward cure or palliation. This article presents a review of radiologic diagnosis and staging of esophageal cancer. PMID:12044696

Kumbasar, Basak

2002-06-01

82

[Reflux esophagitis (esophageal hiatus hernia)].  

PubMed

Recently, the guidelines for the treatment of gastroesophageal reflux disease (GERD) by the Japanese Society of Gastroenterology. There are many statements including recommended grade (from A to D) and evidence level (from I to VI) for the epidemiology, pathogenesis, diagnosis, medical treatments, surgical treatment of GERD, reflux esophagitis after gastrectomy, and non-typical symptoms of GERD. In this manuscript, we showed the latest date and current status of GERD in Japan used this guidelines. In summary, the prevalence of GERD has been increasing since the end of 1990s, the 1st choice of medical treatment is proton pump inhibitors, endoscopic treatments for GERD are not available in Japan, laparoscopic Toupet fundoplication is superior to laparoscopic Nissen fundoplication as postoperative dysphagia with similar reflux control, and complications of surgical treatment are pneumothorax, splenic injury, aortic injury, gastric ulcer, sever dysphagia, gastric perforation etc., but complication rate is low. PMID:21916192

Omura, Nobuo; Kashiwagi, Hideyuki

2011-07-01

83

40 CFR 147.2000 - State-administered program-Class I, II, III, IV, and V wells.  

Code of Federal Regulations, 2013 CFR

...program-Class I, II, III, IV, and V wells. 147.2000 Section 147.2000 Protection of Environment ENVIRONMENTAL PROTECTION...INJECTION CONTROL PROGRAMS Rhode Island § 147.2000 State-administered programâClass I, II,...

2013-07-01

84

Introducing a mixed-valent dirhodium(II,III) catalyst with increased stability in C-H amination.  

PubMed

A new mixed-valent Rh(2)(II,III) dimer, [Rh(2)(espn)(2)Cl] (espn(2-) = ?,?,?',?'-tetramethyl-1,3-benzenedipropanamidate), is reported. This compound readily dissociates Cl(-) at low concentrations in solution to form the active [Rh(2)(espn)(2)](+) catalyst, which performs intramolecular C-H amination with TONs > 1400. This work expands the scope of Rh(2)(II,III) dimers to nitrenoid chemistry. PMID:23135250

Kornecki, Katherine P; Berry, John F

2012-11-07

85

Elective lymph node irradiation late course accelerated hyper-fractionated radiotherapy plus concurrent cisplatin-based chemotherapy for esophageal squamous cell carcinoma: a phase II study  

PubMed Central

Background In this phase II study, we evaluated the efficacy, toxicity, and patterns of failure of elective lymph node irradiation (ENI) late course accelerated hyper-fractionated radiotherapy (LCAHRT) concurrently with cisplatin-based chemotherapy (CHT) for esophageal squamous cell carcinoma (ESCC). Methods Patients with clinical stage II-IVa (T1-4N0-1M0 or M1a) ESCC were enrolled between 2004 and 2011. Radiation therapy (RT) comprised two courses: The first course of radiation covered the primary and metastatic regional tumors and high risk lymph nodal regions, given at 2 Gy per fraction for a dose of 40 Gy. In the second course, LCAHRT was delivered to the boost volume twice a day for an additional 19.6 Gy in 7 treatment days, using 1.4 Gy per fraction. Two cycles of CHT were given at the beginning of RT. Results The median age and Karnofsky performance status were 63 years and 80, respectively. The American Joint Committee on Cancer stage was II in 14 (20.6%) patients, III in 32 (47.1%), and IVa in 22 (32.3%). With a median follow-up of 18.5 months, the overall survival at 1-, 3-, 5-year were 75.5%, 46.5%, 22.7% for whole group patients, versus 78.6%, 49.4%, 39.9% for patients with stage II–III. The patterns of first failure from local recurrence, regional failure, and distant metastasis were seen in 20.6%, 17.6%, and 19.1%, respectively. The most frequent acute high-grade (? 3) toxicities were esophagitis and leucopenia, occurred in 26.4% and 32.4%. Conclusions ENI LCAHRT concurrently with CHT was appeared to be an effective regimen for ESCC patient with a favorable and tolerated profile. Further observation with longer time and randomized phase III trial is currently underway. Trial registration ChiCTR-TRC-09000568

2013-01-01

86

Multidisciplinary approach for patients with esophageal cancer  

PubMed Central

Patients with esophageal cancer have a poor prognosis because they often have no symptoms until their disease is advanced. There are no screening recommendations for patients unless they have Barrett’s esophagitis or a significant family history of this disease. Often, esophageal cancer is not diagnosed until patients present with dysphagia, odynophagia, anemia or weight loss. When symptoms occur, the stage is often stage III or greater. Treatment of patients with very early stage disease is fairly straight forward using only local treatment with surgical resection or endoscopic mucosal resection. The treatment of patients who have locally advanced esophageal cancer is more complex and controversial. Despite multiple trials, treatment recommendations are still unclear due to conflicting data. Sadly, much of our data is difficult to interpret due to many of the trials done have included very heterogeneous groups of patients both histologically as well as anatomically. Additionally, studies have been underpowered or stopped early due to poor accrual. In the United States, concurrent chemoradiotherapy prior to surgical resection has been accepted by many as standard of care in the locally advanced patient. Patients who have metastatic disease are treated palliatively. The aim of this article is to describe the multidisciplinary approach used by an established team at a single high volume center for esophageal cancer, and to review the literature which guides our treatment recommendations.

Villaflor, Victoria M; Allaix, Marco E; Minsky, Bruce; Herbella, Fernando A; Patti, Marco G

2012-01-01

87

Coprecipitation of Fe(II–III) hydroxycarbonate green rust stabilised by phosphate adsorption  

Microsoft Academic Search

[FeII4FeIII2(OH)12]2+•[CO3, nH2O]2? green rust one, GR1(CO32?), was synthesised by coprecipitation in the presence of phosphate by dissolving a Na2HPO4 salt. In its absence, the resulting product is a mixture of Fe(II–III) hydroxysalt, magnetite Fe3O4 and ferrous hydroxide Fe(OH)2. In the presence of phosphate as low as {[PO4]min0\\/[Fe]}?1%, the resulting product is GR1(CO32?) alone. No P was detected by TEM-EDX when

Florent Bocher; Antoine Géhin; Christian Ruby; Jaafar Ghanbaja; Mustapha Abdelmoula; Jean-Marie R. Génin

2004-01-01

88

Carcinoma of esophagus: radiologic diagnosis and staging  

Microsoft Academic Search

Esophageal carcinoma is an uncommon malignancy accounting for approximately 7% of gastrointestinal tract cancers and 1% of all cancers. Esophageal cancer still remains one of the most lethal of all cancers. Since a multimodality approach is presently used to treat esophageal cancer, early radiologic diagnosis and accurate tumor staging are essential to direct therapy toward cure or palliation. This article

Basak Kumbasar

2002-01-01

89

Low platelet mitochondrial complex I and complex II/III activity in early untreated Parkinson's disease.  

PubMed

Following the discovery of inhibition of electron transport complex 1 by the neurotoxin 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP), which produces a parkinsonian syndrome in humans, monkeys, and mice, several laboratories have reported abnormalities of complex I and other electron transport complexes (ETCs) in various tissues from patients with Parkinson's disease (PD). Criticism of the significance of these findings in the etiology of PD has centered on whether drug treatments or the debilitation of the disease process itself produced the low ETC activities. We present results from a blinded study of platelet mitochondrial ETC activities in 18 early untreated PD patients and 18 age- and sex-matched controls and in 13 spousal controls. Lower complex I activity in platelet mitochondria of PD patients was seen in early untreated disease and thus cannot be due to debilitation or drug therapy. Home environmental factors seem an unlikely explanation for the reduced complex I activity in PD patients but have not been excluded. Complex II/III activity was also reduced by 20% in PD compared with age-/sex-matched controls. The low complex I and II/III activities in platelet mitochondria appear to be related to the etiology of PD. PMID:7778844

Haas, R H; Nasirian, F; Nakano, K; Ward, D; Pay, M; Hill, R; Shults, C W

1995-06-01

90

Aluminium substitution in iron(II III)-layered double hydroxides: Formation and cationic order  

NASA Astrophysics Data System (ADS)

The formation and the modifications of the structural properties of an aluminium-substituted iron(II III)-layered double hydroxide (LDH) of formula Fe4IIFe(2-6y)IIIAl6yIII (OH)12 SO4, 8H2O are followed by pH titration curves, Mössbauer spectroscopy and high-resolution X-ray powder diffraction using synchrotron radiation. Rietveld refinements allow to build a structural model for hydroxysulphate green rust, GR(SO42-), i.e. y=0, in which a bilayer of sulphate anions points to the Fe3+ species. A cationic order is proposed to occur in both GR(SO42-) and aluminium-substituted hydroxysulphate green rust when y<0.08. Variation of the cell parameters and a sharp decrease in average crystal size and anisotropy are detected for an aluminium content as low as y=0.01. The formation of Al-GR(SO42-) is preceded by the successive precipitation of FeIII and AlIII (oxy)hydroxides. Adsorption of more soluble AlIII species onto the initially formed ferric oxyhydroxide may be responsible for this slowdown of crystal growth. Therefore, the insertion of low aluminium amount (y˜0.01) could be an interesting way for increasing the surface reactivity of iron(II III) LDH that maintains constant the quantity of the reactive FeII species of the material.

Ruby, Christian; Abdelmoula, Mustapha; Aissa, Rabha; Medjahdi, Ghouti; Brunelli, Michela; François, Michel

2008-09-01

91

Mössbauer study of magnetism in FeII - III (oxy-)hydroxycarbonate green rusts; ferrimagnetism of FeII - III hydroxycarbonate  

NASA Astrophysics Data System (ADS)

FeII - III hydroxycarbonate Fe^II4Fe^III2(OH)12CO3, green rust GR(CO3^{2-}), reveals a ferrimagnetic behaviour. Moments that lie within two-dimensional cation layers are parallel for same species and antiparallel between FeII and FeIII. Respective ordering temperatures are 5.2 and 7 K. A sextet with distribution from 350 to 580 kOe for FeIII and an octet reflecting a mixture of states with field of 130 kOe and quadrupole splitting of -3.0 mm s - 1 for FeII are observed at 1.4 K. Ferric oxyhydroxycarbonate Fe^III6O12H8CO3 is ferromagnetic and displays at 4 K a sextet with field between 400 and 500 kOe (maximum at 480 kOe) and transition at 80 K. GR(CO3^{2-}) deprotonation gives magnetic domains with compositions at x = 1/3, 2/3 and 1 due to long range order.

Rusch, B.; Génin, J.-M. R.; Ruby, Ch.; Abdelmoula, M.; Bonville, P.

2008-11-01

92

Cyclization of the intrinsically disordered ?1S dihydropyridine receptor II-III loop enhances secondary structure and in vitro function.  

PubMed

A key component of excitation contraction (EC) coupling in skeletal muscle is the cytoplasmic linker (II-III loop) between the second and third transmembrane repeats of the ?(1S) subunit of the dihydropyridine receptor (DHPR). The II-III loop has been previously examined in vitro using a linear II-III loop with unrestrained N- and C-terminal ends. To better reproduce the loop structure in its native environment (tethered to the DHPR transmembrane domains), we have joined the N and C termini using intein-mediated technology. Circular dichroism and NMR spectroscopy revealed a structural shift in the cyclized loop toward a protein with increased ?-helical and ?-strand structure in a region of the loop implicated in its in vitro function and also in a critical region for EC coupling. The affinity of binding of the II-III loop binding to the SPRY2 domain of the skeletal ryanodine receptor (RyR1) increased 4-fold, and its ability to activate RyR1 channels in lipid bilayers was enhanced 3-fold by cyclization. These functional changes were predicted consequences of the structural enhancement. We suggest that tethering the N and C termini stabilized secondary structural elements in the DHPR II-III loop and may reflect structural and dynamic characteristics of the loop that are inherent in EC coupling. PMID:21525002

Tae, Han-Shen; Cui, Yanfang; Karunasekara, Yamuna; Board, Philip G; Dulhunty, Angela F; Casarotto, Marco G

2011-04-27

93

Cyclization of the Intrinsically Disordered ?1S Dihydropyridine Receptor II-III Loop Enhances Secondary Structure and in Vitro Function*  

PubMed Central

A key component of excitation contraction (EC) coupling in skeletal muscle is the cytoplasmic linker (II-III loop) between the second and third transmembrane repeats of the ?1S subunit of the dihydropyridine receptor (DHPR). The II-III loop has been previously examined in vitro using a linear II-III loop with unrestrained N- and C-terminal ends. To better reproduce the loop structure in its native environment (tethered to the DHPR transmembrane domains), we have joined the N and C termini using intein-mediated technology. Circular dichroism and NMR spectroscopy revealed a structural shift in the cyclized loop toward a protein with increased ?-helical and ?-strand structure in a region of the loop implicated in its in vitro function and also in a critical region for EC coupling. The affinity of binding of the II-III loop binding to the SPRY2 domain of the skeletal ryanodine receptor (RyR1) increased 4-fold, and its ability to activate RyR1 channels in lipid bilayers was enhanced 3-fold by cyclization. These functional changes were predicted consequences of the structural enhancement. We suggest that tethering the N and C termini stabilized secondary structural elements in the DHPR II-III loop and may reflect structural and dynamic characteristics of the loop that are inherent in EC coupling.

Tae, Han-Shen; Cui, Yanfang; Karunasekara, Yamuna; Board, Philip G.; Dulhunty, Angela F.; Casarotto, Marco G.

2011-01-01

94

Esophageal dilation \\/ dilators  

Microsoft Academic Search

Opinion statement  Esophageal dilation is the treatment of choice for most patients with esophageal dysphagia (functional and mechanical). Multiple\\u000a forms of esophageal dilators are available. Mechanical dilators (guidewire\\/nonguidewire assisted) are the major forms of dilators\\u000a used. Balloon dilator use has increased but they offer only a marginal advantage over traditional mechanical dilators at a\\u000a greatly increased cost (2° to single use).

Timothy T. Nostrant

2005-01-01

95

When is esophagitis healed?  

Microsoft Academic Search

In order to asses whether in reflux esophagitis morphological and functional disorders persist after macroscopic healing, cimetidine was given for 6–12 weeks at a dose of 1.6 g\\/day to 30 patients with acid gastroesophageal reflux and esophagitis. The mucosal defects healed in 6 patients, improved in 14 patients, and remained unchanged in 10 patients. Lower esophageal sphincter pressure, acid clearance,

Amnon Sonnenberg; Gerd Lepsien; STEFAN A. MISILLER-LISSNER; Hans R. Koelz; J. Rüdiger Siewert; André L. Blum

1982-01-01

96

Lower esophageal sphincter pressure in histologic esophagitis.  

PubMed

The fasting lower esophageal sphincter pressure of 18 normal volunteers was compared to 22 patients with symptoms and objective evidence of gastroesophageal reflux. Lower esophageal sphincter pressure was measured by rapid pull-through using an 8-lumen radially perfused catheter that sampled pressure every45 degrees around the circumference of the sphincter. The 22 reflux patients were subdivided for analysis into two groups, those with an acute inflammatory infiltrate on biopsy and those without inflammation. Those patients without inflammatory esophagitis had normal sphincter pressures. Those with a definite inflammatory infiltrate had pressures significantly less than normal. The least reliable separation between normals and those with inflammatory esophagitis occurred in the anterior orientations. We conclude that while basal lower esophageal sphincter pressure measurement may identify patients with reflux and inflammatory esophagitis, it is of no help in identifying those patients with reflux unassociated with inflammation. Decreased basal fasting LESP does not appear to be the most important primary determinant of gastroesophageal reflux. PMID:7379675

Welch, R W; Luckmann, K; Ricks, P; Drake, S T; Bannayan, G; Owensby, L

1980-06-01

97

The 2002 AJCC TNM classification is a better predictor of primary small cell esophageal carcinoma outcome than the VALSG staging system.  

PubMed

Small cell carcinoma of the esophagus (SCCE) is a rare and aggressive malignant tumor with a poor prognosis. The optimal disease staging system and treatment approaches have not yet been defined. This study aimed to evaluate the prediction of different staging systems for prognosis and treatment options of SCCE. We retrospectively accessed the clinicopathologic characteristics, treatment strategy, and prognosis of 76 patients diagnosed with primary SCCE between 2001 and 2011. The 1-, 2-, 3-, and 5-year overall survival rates were 58%, 31%, 19%, and 13%, respectively. Univariate analysis showed that the 2002 American Joint Committee on Cancer (AJCC) tumor-node-metastasis (TNM) classification (P = 0.002), Veterans Administration Lung Study Group (VALSG) stage (P = 0.001), predisposing factors (P < 0.001), T category (P = 0.023), and M category (P < 0.001) were prognostic factors for overall survival. Multivariate analysis showed that the 2002 AJCC TNM stage (P < 0.001) was the only independent prognostic factor for survival. The value of the area under the receiver operator characteristic (ROC) curve (AUC) of the 2002 AJCC TNM staging system was larger than that of VALSG staging system with regard to predicting overall survival (0.774 vs. 0.620). None of the single treatment regimens showed any benefit for survival by Cox regression analysis. Thus, the 2002 AJCC TMN staging system improved the prediction of SCCE prognosis; however, the optimal treatment regimen for SCCE remains unclear. PMID:23114087

Wang, Sheng-Ye; Mao, Wei-Ming; Du, Xiang-Hui; Xu, Ya-Ping; Zhang, Su-Zhan

2012-10-10

98

Functional esophageal disorders  

PubMed Central

The functional esophageal disorders include globus, rumination syndrome, and symptoms that typify esophageal diseases (chest pain, heartburn, and dysphagia). Factors responsible for symptom production are poorly understood. The criteria for diagnosis rest not only on compatible symptoms but also on exclusion of structural and metabolic disorders that might mimic the functional disorders. Additionally, a functional diagnosis is precluded by the presence of a pathology-based motor disorder or pathological reflux, defined by evidence of reflux esophagitis or abnormal acid exposure time during ambulatory esophageal pH monitoring. Management is largely empirical, although efficacy of psychopharmacological agents and psychological or behavioral approaches has been established for serveral of the functional esophageal disorders. As gastroesophageal reflux disease overlaps in presentation with most of these disorders and because symptoms are at least partially provoked by acid reflux events in many patients, antireflux therapy also plays an important role both in diagnosis and management. Further understanding of the fundamental mechanisms responsible for symptoms is a priority for future research efforts, as is the consideration of treatment outcome in a broader sense than reduction in esophageal symptoms alone. Likewise, the value of inclusive rather than restrictive diagnostic criteria that encompass other gastrointestinal and non-gastrointestinal symptoms should be examined to improve the accuracy of symptom-based criteria and reduce the dependence on objective testing.???Keywords: globus; rumination; chest pain; esophageal motility disorders; esophageal spasm; gastroesophageal reflux disease; Rome II

Clouse, R; Richter, J; Heading, R; Janssens, J; Wilson, J

1999-01-01

99

Bleeding esophageal varices  

MedlinePLUS

... they can bleed severely. Any type of chronic liver disease can cause esophageal varices. Varices can also occur ... People with chronic liver disease and esophageal varices may have no symptoms. If there is only a small amount of bleeding, the only symptom ...

100

Chemoprevention of esophageal squamous cell carcinoma  

SciTech Connect

Esophageal squamous cell carcinoma (SCC) is responsible for approximately one-sixth of all cancer-related mortality worldwide. This malignancy has a multifactorial etiology involving several environmental, dietary and genetic factors. Since esophageal cancer has often metastasized at the time of diagnosis, current treatment modalities offer poor survival and cure rates. Chemoprevention offers a viable alternative that could well be effective against the disease. Clinical investigations have shown that primary chemoprevention of this disease is feasible if potent inhibitory agents are identified. The Fischer 344 (F-344) rat model of esophageal SCC has been used extensively to investigate the biology of the disease, and to identify chemopreventive agents that could be useful in human trials. Multiple compounds that inhibit tumor initiation by esophageal carcinogens have been identified using this model. These include several isothiocyanates, diallyl sulfide and polyphenolic compounds. These compounds influence the metabolic activation of esophageal carcinogens resulting in reduced genetic (DNA) damage. Recently, a few agents have been shown to inhibit the progression of preneoplastic lesions in the rat esophagus into tumors. These agents include inhibitors of inducible nitric oxide synthase (iNOS), cyclooxygenase-2 (COX-2), vascular endothelial growth factor (VEGF) and c-Jun [a component of activator protein-1 (AP-1)]. Using a food-based approach to cancer prevention, we have shown that freeze-dried berry preparations inhibit both the initiation and promotion/progression stages of esophageal SCC in F-344 rats. These observations have led to a clinical trial in China to evaluate the ability of freeze-dried strawberries to influence the progression of esophageal dysplasia to SCC.

Stoner, Gary D. [Division of Hematology and Oncology, Department of Internal Medicine, Ohio State University College of Medicine and Comprehensive Cancer Center, Columbus, OH 43210 (United States)], E-mail: gary.stoner@osumc.edu; Wang Lishu; Chen Tong [Division of Hematology and Oncology, Department of Internal Medicine, Ohio State University College of Medicine and Comprehensive Cancer Center, Columbus, OH 43210 (United States)

2007-11-01

101

Synthesis and electrocatalytic activity of haemin-functionalised iron(II, III) oxide nanoparticles.  

PubMed

Haemin-functionalised magnetic iron(II, III) oxide (Fe3O4) nanoparticles (Fe3O4/haemin) were synthesised by changing the acidity of a solution of the two compounds. The nanoparticles were characterised by transmission electron microscopy, UV-vis absorption spectroscopy, X-ray diffraction, Fourier transform infrared spectroscopy, measurement of magnetisation, and electrochemical techniques. The properties of both haemin and Fe3O4 were retained. Thus, Fe3O4/haemin nanoparticles exhibited pronounced electrocatalytic activity towards trichloroacetic acid (TCA) like haemin itself. Interestingly, electrocatalytic activity towards TCA was affected by detection temperature, which was controlled via electrically heated carbon paste electrodes. The maximal catalytic current was 5.8 times higher at 60°C than at room temperature (25°C). This proposed electrochemical sensor for TCA possessed a linear detection range of 5-80 ?M and a detection limit of 0.3 ?M at 60°C. PMID:23684464

Yin, Zheng-Zhi; Li, Yongjie; Jiang, Li-Ping; Rana, Rohit Kumar; Zhu, Jun-Jie

2013-04-16

102

Resonant L{sub II,III} x-ray Raman scattering from HCl  

SciTech Connect

We have studied the spectral features of Cl L{sub II,III} resonant x-ray Raman scattering of HCl molecules in gas phase both experimentally and theoretically. The theory, formulated in the intermediate-coupling scheme, takes into account the spin-orbital and molecular-field splittings in the Cl 2p shells, as well as the Coulomb interaction of the core hole with unoccupied molecular orbitals. Experiment and theory display nondispersive dissociative peaks formed by decay transitions in both molecular and dissociative regions. The molecular and atomic peaks collapse in a single narrow resonance because the dissociative potentials of core-excited and final states are parallel to each other along the whole pathway of the nuclear wave packet.

Saathe, C.; Rubensson, J.-E.; Nordgren, J. [Department of Physics, Uppsala University, Box 530, S-751 21 Uppsala (Sweden); Guimaraes, F. F. [Theoretical Chemistry, Roslagstullsbacken 15, Royal Institute of Technology, S-106 91 Stockholm (Sweden); Departamento de Quimica, Universidade Federal de Minas Gerais, Avenue Antonio Carlos, 6627, CEP-31270-901, Belo Horizonte, MG (Brazil); Agui, A. [Synchrotron Radiation Research Unit, Japan Atomic Energy Agency, 1-1-1 Kouto, Sayo-cho, Sayogun, Hyogo 679-5148 (Japan); Guo, J. [Advanced Light Source, Lawrence Berkeley National Laboratory, MS 6R2100, One Cyclotron Road, Berkeley, California 94720 (United States); Ekstroem, U.; Norman, P. [Department of Physics, Chemistry and Biology, Linkoeping University, SE-581 83 Linkoeping (Sweden); Gel'mukhanov, F.; Aagren, H. [Theoretical Chemistry, Roslagstullsbacken 15, Royal Institute of Technology, S-106 91 Stockholm (Sweden)

2006-12-15

103

Pathogenesis of esophageal rings in eosinophilic esophagitis.  

PubMed

Eosinophilic esophagitis and eosinophilic gastroenteritis is being recognized more frequently among the adult patients. The disease is characterized by massive infiltration of the wall of gastrointestinal tract by sheets of eosinophils. The clinical features depend upon the site of involvement. They include dyspepsia, dysphagia, nausea, vomiting, chest pain, diarrhea and protein-losing enteropathy. Eosinophilic esophagitis may present as chest pain, dysphagia or dyspepsia. The characteristic endoscopic feature of eosinophilic esophagitis is the formation of fine concentric mucosal rings (corrugated esophagus). Regarding the pathogenesis of these mucosal rings our hypothesis is that mast cells in the esophageal wall in response to allergens release histamine, eosinophilic chemotactic factor and platelet activating factor, etc. which activate eosinophils to release toxic cationic proteins. Activation of acetyl choline by histamine may cause contraction of the muscle fibers in the muscularis mucosae resulting in the formation of esophageal rings. This hypothesis can be tested by demonstrating the contraction of muscle layers of muscularis mucosae with the use of high frequency endoscopic ultrasonic probe introduced via the biopsy channel of an endoscope. PMID:15617859

Mann, N S; Leung, J W

2005-01-01

104

MicroRNA and its roles in esophageal cancer  

PubMed Central

Summary Esophageal cancer is the eighth most common cancer and causes the sixth highest cancer-related mortality worldwide. The 5-year survival of patients suffering from esophageal cancer in either advanced stage or metastasis is less than 20%. MicroRNAs are small, well conserved, non-coding RNA molecules that either repress translation or promote mRNA degradation based on the degree of complementary between miRNAs and mRNAs. Based on biogenesis and function of microRNAs, specific microRNA profiles, either from cancerous tissues or serum, were able to serve as diagnostic and prognostic biomarkers of esophageal cancer and predicted the effectiveness of surgery and chemoradiotherapy. MicroRNAs could also influence the biological behaviors of esophageal cancer cells, such as cellular proliferation, apoptosis, invasion and metastasis. MicroRNAs were also associated with multi-drug resistance of esophageal cancer. Further studies on the roles of microRNAs in esophageal cancer would provide a strategy to prevent and treat esophageal cancer, and reverse multi-drug resistance of esophageal cancer.

Fang, Yu; Fang, Dianchun; Hu, Jianguo

2012-01-01

105

ROLE OF IRON (II, III) HYDROXYCARBONATE GREEN RUST IN ARSENIC REMEDIATION USING ZEROVALENT IRON IN COLUMN TESTS  

EPA Science Inventory

We examined corrosion products of zerovalent iron (Peerless iron) that was used in three column tests for removing arsenic under dynamic flow conditions with and without added phosphate and silicate. Iron(II, III) hydroxycarbonate and magnetite were major iron corrosion products...

106

[Reflux, smoking, alcohol. Approach to prevention of esophageal carcinoma].  

PubMed

In western industrialized countries, esophageal cancer is a rare entity. While smoking and alcohol are the major risk factors for squamous cell carcinoma, the most important etiological factor for adenocarcinoma is Barrett's esophagus caused by gastro-esophageal reflux. Over the past few decades there has been a dramatic increase in the incidence of adenocarcinoma. The prognosis for both types of esophageal cancer is poor, with a 5-year survival rate of < 10%. Only early stages have a good prognosis. While prevention of squamous cell carcinoma is limited to avoiding drinking and smoking, prevention of adenocarcinoma requires endoscopic surveillance of Barrett's esophagus and the treatment of any dysplasia arising in it. PMID:12198874

Rotthauwe, J; Lingenfelser, Th; Malfertheiner, P

2002-07-11

107

Significance of Platelet Count in Esophageal Carcinomas  

PubMed Central

Background/Aim: Thrombocytosis is found to be associated with unfavorable prognosis in esophageal carcinoma. Platelets produce thymidine phosphorylase which is a platelet-derived endothelial cell growth factor with angiogenic activity. Increased platelet count may be translated into enhanced tumor growth. We examined the relation between platelet count and several prognostic variables in patients with esophageal cancer. Patients and Methods: Three hundred and eighty-one cases with esophageal cancer that underwent esophagectomy in a referral cancer institute during a 5-year period were studied retrospectively. The relation between preoperative platelet count and patient age, gender, site of tumor, presence of multiple cancers and clinicopathological characteristics including histological type, tumor size, depth of penetration (T), lymph node involvement (N), distant metastasis (M), degree of differentiation, presence of vascular, lymphatic and perineural invasion was examined. Results: Squamous cell carcinoma (SCC) constituted 93% and adenocarcinoma 7% of cases. Most of patients were in stage III, followed by stage II. The mean platelet count was 245±76 (× 109 /L). There was no statistically significant correlation between platelet counts with prognostic factors except a weak linear correlation between platelet count and and tumor size (P= 0.03, Pearson correlation coefficient: 0.16). Patients with adenocarcinoma had a higher platelet count than those with SCC (P= 0.003). Conclusion: Platelet count does not correlate with prognostic factors in esophageal cancer. However, it is significantly different between SCC and adenocarcinoma of esophagus.

Aminian, Ali; Karimian, Faramarz; Mirsharifi, Rasoul; Alibakhshi, Abbas; Dashti, Habibollah; Jahangiri, Yosra; Safari, Saeed; Ghaderi, Hamid; Noaparast, Morteza; Hasani, Sharareh M.; Mirsharifi, Alireza

2011-01-01

108

Circulating microRNAs: Novel biomarkers for esophageal cancer  

Microsoft Academic Search

Esophageal carcinogenesis is a multi-stage process, involving a variety of changes in gene expression and physiological structure change. MicroRNAs (miRNAs) are a class of small non-coding endogenous RNA molecules. Recent innovation in miRNAs profiling technology have shed new light on the pathology of esophageal carci- noma (EC), and also heralded great potential for explor- ing novel biomarkers for both EC

Sheng-Li Zhou; Li-Dong Wang; Mitsuyoshi Urashima

2010-01-01

109

Metastasis of Esophageal Cancer.  

National Technical Information Service (NTIS)

Metastatic involvement (59.2%) was noted in esophageal cancer during autopsy on 710 cases, with lymphogenic metastasis predominating over hematogenic metastasis. In those dying soon after radiation therapy there were metastasis in 49% and in 30% after sur...

A. I. Pirogov V. D. Ryndin

1974-01-01

110

Esophageal Cancer (PDQ): Prevention  

MedlinePLUS

... the type of cells that become malignant (cancerous): Squamous cell carcinoma : Cancer that begins in squamous cells , the thin, ... chance of developing esophageal cancer increases with age. Squamous cell carcinoma of the esophagus is more common in blacks ...

111

Genetics of Eosinophilic Esophagitis.  

National Technical Information Service (NTIS)

Eosinophilic esophagitis (EE) is an emerging worldwide food allergic disorder associated with polysensitization to multiple food allergens, resulting in greatly restricted diets and chronic gastroesophageal reflux disease-like symptoms in many individuals...

M. E. Rothenberg

2011-01-01

112

Genetics of Eosinophilic Esophagitis.  

National Technical Information Service (NTIS)

Eosinophilic esophagitis (EE) is an emerging worldwide food allergic disorder associated with polysensitization to multiple food allergens, resulting in greatly restricted diets and chronic gastroesophageal reflux disease-like symptoms in many individuals...

M. Rothenberg

2012-01-01

113

Squamous cell carcinoma in an esophageal diverticulum below the aortic arch  

PubMed Central

INTRODUCTION Esophageal diverticula frequently arise from pharyngoesophageal transition area, tracheal bifurcation and epiphrenic region. Carcinoma arising from esophageal diverticulum is rarely seen. We report a patient with a squamous cell carcinoma arising within an esophageal diverticulum below the aortic arch. PRESENTATION OF CASE A 70-year-old man was diagnosed to have a squamous cell carcinoma of the vocal cord with enlarged lymph nodes in the neck, as well as a squamous cell carcinoma arising within an esophageal diverticulum below the aortic arch. There have been no reported cases of esophageal cancer arising from a diverticulum below the aortic arch. Preoperative radiotherapy for the esophageal cancer and pharyngeal cancer was given, followed by surgery. The excised specimen of the esophageal diverticulum and its external appearance revealed that it lacked muscle fibers, with a type 0-IIa lesion arising from the diverticulum. Microscopic examination showed three lymph nodes at the superior mediastinum were positive for malignancy. Bilateral pleural dissemination was detected 7 months after esophagectomy. DISCUSSION Cancer arising from an esophageal diverticulum is mainly found at an advanced stage because of delayed diagnosis. The absence of muscularis propia may lead to early invasion. Thus, cancers within an esophageal diverticulum are considered to be at a more advanced stage than similar cancers arising elsewhere. CONCLUSION For detecting of cancer arising from an esophageal diverticulum, a high index of awareness is important. Delay in diagnosis makes surgical management difficult.

Wakita, Akiyuki; Motoyama, Satoru; Sato, Yusuke; Yoshino, Kei; Sasaki, Tomohiko; Saito, Hajime; Minamiya, Yoshihiro; Ogawa, Jun-ichi

2012-01-01

114

Esophageal eosinophilia with dysphagia  

Microsoft Academic Search

Small numbers of intraepithelial esophageal eosinophils (IEE) may be seen in 50% of patients with gastroesophageal reflux disease and occasionally in normal volunteers. High concentrations of IEE are rarely seen in either setting. During a two-year period we idetified 12 adult patients with very dense eosinophil infiltrates in esophageal biopsies (defined as >20 IEE\\/high-power field). Dysphagia was the presenting complaint

Stephen E. A. Attwood; Thomas C. Smyrk; Tom R. Demeester; James B. Jones

1993-01-01

115

Correlations between selected tumor markers and fluorodeoxyglucose maximal standardized uptake values in esophageal cancer  

Microsoft Academic Search

Objective: Esophageal cancer tumor biology is best assessed clinically by 2-[18F]fluoro-2-deoxy-d-glucose (FDG)-PET. Both FDG-PET maximal positron emission tomography (PET) standardized uptake values (SUVmax) and selected tumor markers have been shown to correlate with stage, nodal disease, and survival in esophageal cancer. Interestingly, there is limited data examining the relationship between FDG-PET SUVmax and expression of these tumor markers in esophageal

Matthew D. Taylor; Philip W. Smith; William K. Brix; Mark R. Wick; Nicholas Theodosakis; Brian R. Swenson; Benjamin D. Kozower; David R. Jones

2009-01-01

116

Investigation of the enhancement of N-nitrosomethylbenzylamine-induced esophageal tumorigenesis by 6-phenylhexyl isothiocyanate  

Microsoft Academic Search

Previous studies in our laboratory have shown that 6-phenylhexyl isothiocyanate (PHITC), enhances N-nitrosomethylbenzylamine (NMBA)-induced esophageal tumorigenesis in F344 rats while the shorter chain analogs, phenylethyl isothiocyanate (PEITC), and 3-phenylpropyl isothiocyanate (PPITC), inhibit NMBA-induced esophageal tumorigenesis. To test the hypothesis that PHITC influences the promotional stage of esophageal tumorigenesis, groups of 22–27 rats were dosed with vehicle or NMBA three times

Tamaro S. Hudson; Peter S. Carlton; Ashok Gupta; Gary D. Stoner; Mark A. Morse

2001-01-01

117

In situ redox flexibility of FeII-III Oxyhydroxycarbonate green rust and fougerite.  

PubMed

Bacterial activity is commonly thought to be directly responsible for denitrification in soils and groundwater. However, nitrate reduction in low organic sediments occurs abiotically by FeII ions within the fougerite mineral (IMA 2003-057), giving the bluish-green color of gleysols. Fougerite, the mineral counterpart of FeII-III oxyhydroxycarbonate, FeII6(1-x)FeIII6xO12H2(7-3x)CO3, provides a unique in situ redox flexibility, which can adapt x = {[FeIII]/[Fetotal]} between 1/3 and 2/3 as shown using Mössbauer spectroscopy. Chemical potential and Eh-pH diagrams for this system were determined from electrode potential monitored during deprotonation of hydroxycarbonate FeII4FeIII2(OH)12CO3 to assess the possibility of reducing pollutants in the field. Bioreduction of ferric oxyhydroxides in anoxic groundwater yields dissolved FeII, whereas HCO3- anions produced from organic matter are incorporated into fougerite layered double oxyhydroxide structure. Thus, fougerite is the solid-state redox mediator acting as electron shuttle that helps bacterial activity for reducing nitrate by coupling dissimilatory FeIII reduction and oxidation of FeII with reduction of NO3-. It is proposed that this system could be used in the remediation of soils and nitrified waters. PMID:16913126

Ruby, Christian; Upadhyay, Chandan; Géhin, Antoine; Ona-Nguema, Georges; Génin, Jean-Marie R

2006-08-01

118

Synthesis and characterisation of the Fe(II-III) hydroxy-formate green rust  

NASA Astrophysics Data System (ADS)

A new methodology was envisioned in order to prepare green rust compounds build on organic anions that could intervene in microbiologically influenced corrosion processes of iron and steel. The formate ion was chosen as an example. The formation of rust was simulated by the oxidation of aqueous suspensions of Fe(OH)2 precipitated from Fe(II) lactate and sodium hydroxide, in the presence of sodium formate to promote the formation of the corresponding green rust. The evolution of the precipitate with time was followed by transmission Mössbauer spectroscopy at 15 K. It was observed that the initial hydroxide was transformed into a new GR compound. Its spectrum is composed of three quadrupole doublets, D 1 (?=1.28 mm s-1, ?=2.75 mm s-1) and D 2 (?=1.28 mm s-1, ?=2.48 mm s-1) that correspond to Fe(II) and D 3 (?=0.49 mm s-1, ?=0.37 mm s-1) that corresponds to Fe(III). The relative area of D 3, close to the proportion of Fe(III) in the GR, was found at 28.5±1.5% (˜2/7). Raman spectroscopy confirmed that the intermediate compound was a Fe(II-III) hydroxy-formate, GR(HCOO-).

Refait, P.; Abdelmoula, M.; Génin, J.-M. R.; Jeannin, M.

119

Synthesis and characterisation of the Fe(II III) hydroxy-formate green rust  

NASA Astrophysics Data System (ADS)

A new methodology was envisioned in order to prepare green rust compounds build on organic anions that could intervene in microbiologically influenced corrosion processes of iron and steel. The formate ion was chosen as an example. The formation of rust was simulated by the oxidation of aqueous suspensions of Fe(OH)2 precipitated from Fe(II) lactate and sodium hydroxide, in the presence of sodium formate to promote the formation of the corresponding green rust. The evolution of the precipitate with time was followed by transmission Mössbauer spectroscopy at 15 K. It was observed that the initial hydroxide was transformed into a new GR compound. Its spectrum is composed of three quadrupole doublets, D 1 (? = 1.28 mm s-1, ? = 2.75 mm s-1) and D 2 (? = 1.28 mm s-1, ? = 2.48 mm s-1) that correspond to Fe(II) and D 3 (? = 0.49 mm s-1, ? = 0.37 mm s-1) that corresponds to Fe(III). The relative area of D 3, close to the proportion of Fe(III) in the GR, was found at 28.5 ± 1.5% (˜2/7). Raman spectroscopy confirmed that the intermediate compound was a Fe(II III) hydroxy-formate, GR(HCOO-).

Refait, P.; Abdelmoula, M.; Génin, J.-M. R.; Jeannin, M.

2006-01-01

120

Layer-Specific Noradrenergic Modulation of Inhibition in Cortical Layer II/III  

PubMed Central

Norepinephrine (NE) is released in the neocortex after activation of the locus coeruleus of the brain stem in response to novel, salient, or fight-or-flight stimuli. The role of adrenergic modulation in sensory cortices is not completely understood. We investigated the possibility that NE modifies the balance of inhibition acting on 2 different ?-aminobutyric acid (GABA)ergic pathways. Using patch-clamp recordings, we found that the application of NE induces an ?1 adrenergic receptor–mediated decrease of the amplitude of inhibitory postsynaptic currents (IPSCs) evoked by stimulation of layer I (LI-eIPSCs) and a ? and ?2 receptor–mediated increase in the amplitude of IPSCs evoked by stimulation of layer II/III (LII/III-eIPSCs). Analysis of minimal stimulation IPSCs, IPSC kinetics, and sensitivity to the GABAA receptor subunit–selective enhancer zolpidem corroborated the functional difference between LI- and LII/III-eIPSCs, suggestive of a distal versus somatic origin of LI- and LII/III-eIPSCs, respectively. These findings suggest that NE shifts the balance between distal and somatic inhibition to the advantage of the latter. We speculate that such shift modifies the balance of sensory-specific and emotional information in the integration of neural input to the upper layers of the auditory cortex.

Salgado, Humberto; Garcia-Oscos, Francisco; Patel, Ankur; Martinolich, Laura; Nichols, Justin A.; Dinh, Lu; Roychowdhury, Swagata; Tseng, Kuei-Yuan

2011-01-01

121

Layer-specific noradrenergic modulation of inhibition in cortical layer II/III.  

PubMed

Norepinephrine (NE) is released in the neocortex after activation of the locus coeruleus of the brain stem in response to novel, salient, or fight-or-flight stimuli. The role of adrenergic modulation in sensory cortices is not completely understood. We investigated the possibility that NE modifies the balance of inhibition acting on 2 different ?-aminobutyric acid (GABA)ergic pathways. Using patch-clamp recordings, we found that the application of NE induces an ?(1) adrenergic receptor-mediated decrease of the amplitude of inhibitory postsynaptic currents (IPSCs) evoked by stimulation of layer I (LI-eIPSCs) and a ? and ?(2) receptor-mediated increase in the amplitude of IPSCs evoked by stimulation of layer II/III (LII/III-eIPSCs). Analysis of minimal stimulation IPSCs, IPSC kinetics, and sensitivity to the GABA(A) receptor subunit-selective enhancer zolpidem corroborated the functional difference between LI- and LII/III-eIPSCs, suggestive of a distal versus somatic origin of LI- and LII/III-eIPSCs, respectively. These findings suggest that NE shifts the balance between distal and somatic inhibition to the advantage of the latter. We speculate that such shift modifies the balance of sensory-specific and emotional information in the integration of neural input to the upper layers of the auditory cortex. PMID:20466749

Salgado, Humberto; Garcia-Oscos, Francisco; Patel, Ankur; Martinolich, Laura; Nichols, Justin A; Dinh, Lu; Roychowdhury, Swagata; Tseng, Kuei-Yuan; Atzori, Marco

2010-05-13

122

Esophagitis and Barrett esophagus after correction of esophageal atresia  

Microsoft Academic Search

BackgroundGastroesophageal reflux is a frequent problem after esophageal atresia (EA) repair. Our aim was to determine the prevalence of esophagitis and Barrett esophagus more than 10 years after repair of EA.

Jacqueline A. Deurloo; Seine Ekkelkamp; Jan A. J. M. Taminiau; C. M. Frank Kneepkens; Fibo W. J. ten Kate; Joep F. W. M. Bartelsman; Dink A. Legemate; Daniel C. Aronson

2005-01-01

123

Significance of iron(II,III) hydroxycarbonate green rust in arsenic remediation using zerovalent iron in laboratory column tests.  

PubMed

We examined the corrosion products of zerovalent iron used in three column tests for removing arsenic from water under dynamic flow conditions. Each column test lasted 3-4 months using columns consisting of a 10.3-cm depth of 50:50 (w:w, Peerless iron:sand) in the middle and a 10.3cm depth of a sediment from Elizabeth City, NC, in both upper and lower portions of the 31-cm-long glass column (2.5 cm in diameter). The feeding solutions were 1 mg of As(V) L(-1) + 1 mg of As(III) L(-1) in 7 mM NaCl + 0.86 mM CaSO4 with or without added phosphate (0.5 or 1 mg of P L(-1)) and silicate (10 or 20 mg of Si L(-1)) at pH 6.5. Iron(II,III) hydroxycarbonate green rust (or simply, carbonate green rust) and magnetite were the major iron corrosion products identified with X-ray diffraction for the separated fractions (5 and 1 min sedimentation and residual). The presence of carbonate green rust was confirmed by scanning electron microscopy (hexagonal morphology) and FTIR-photoacoustic spectroscopy (interlayer carbonate stretching mode at 1352-1365 cm(-1)). X-ray photoelectron spectroscopy investigation revealed the presence of predominantly As(V) at the surface of corroded iron particles despite the fact that the feeding solution in contact with Peerless iron contained more As(III) than As(V) as a result of a preferential uptake of As(V) over As(III) by the Elizabeth City sediment. Extraction of separated corrosion products with 1.0 M HCI showed that from 86 to 96% of the total extractable As (6.9-14.6 g kg(-1)) was in the form of As(V) in agreement with the XPS results. Combined microscopic and macroscopic wet chemistry results suggest that sorbed As(III) was partially oxidized by the carbonate green rust at the early stage of iron corrosion. The column experiments suggest that either carbonate green rust is kinetically favored or is thermodynamically more stable than sulfate green rust in the studied Peerless iron corrosion systems. PMID:15506221

Su, Chunming; Puls, Robert W

2004-10-01

124

Esophageal Impedance: Role in the Evaluation of Esophageal Motility  

Microsoft Academic Search

The esophagus is a hollow muscular tube with ends closed proximally and distally by muscular sphincters. The upper esophageal sphincter and proximal one third of the esophageal body are composed of striated muscle. There is then a transition zone where striated and smooth muscle mix together. The lower esophageal sphincter and the distal one half to two thirds of the

Chien-Lin Chen

2009-01-01

125

Diffuse Esophageal Spasm: Not Diffuse but Distal Esophageal Spasm (DES)  

Microsoft Academic Search

Diffuse esophageal spasm is an uncommon motility disorder that is found in less than 5% of patients undergoing esophageal motility testing for dysphagia. It is defined manometrically by the presence of 20% or more simultaneous contractions in the distal esophageal body with normal peristalsis. This motility abnormality has been traditionally identified as occurring primarily in the smooth muscle portion of

Monicca Sperandio; Radu Tutuian; R. Matthew Gideon; Philip O. Katz; Donald O. Castell

2003-01-01

126

Esophageal duplication cyst with esophageal web and tracheoesophageal fistula  

Microsoft Academic Search

The authors report the case of lower carvical\\/ upper thoracic esophageal duplication associated with an obstructing esophageal web. This presented in the newborn period as an esophageal atresia. Initial resection of the web and closure of the fistula were performed. The duplication was excised electively at 2 months of age. Persistent symptomatic tracheomalacia required aortopexy, after which the child recovered

Charles L Snyder; Steven W Bickler; George K Gittes; V Ramachandran; Keith W Ashcraft

1996-01-01

127

Achalasia and Esophageal Motility Disorders  

MedlinePLUS

... tests to evaluate for achalasia and other esophageal motility disorders is manometry. This test is performed on an outpatient basis. A small ... coordination of contractions of the esophageal muscles. Some motility disorders, including ... TREATMENTS ARE AVAILABLE FOR ACHALASIA? Endoscopic Treatment ...

128

Esophageal Atresia and Tracheoesophageal Fistula  

MedlinePLUS

MENU Return to Web version Esophageal Atresia and Tracheoesophageal Fistula Overview What is esophageal atresia? In babies who ... swallows gets into the stomach. What is a tracheoesophageal fistula? A fistula (say “fist-you-lah”) is a ...

129

Timing-based LTP and LTD at vertical inputs to layer II/III pyramidal cells in rat barrel cortex.  

PubMed

Experience-dependent plasticity in somatosensory (S1) and visual (V1) cortex involves rapid depression of responses to a deprived sensory input (a closed eye or a trimmed whisker). Such depression occurs first in layer II/III and may reflect plasticity at vertical inputs from layer IV to layer II/III pyramids. Here, I describe a timing-based, associative form of long-term potentiation and depression (LTP/LTD) at this synapse in S1. LTP occurred when excitatory postsynaptic potentials (EPSPs) led single postsynaptic action potentials (APs) within a narrow temporal window, and LTD occurred when APs led EPSPs within a significantly broader window. This long LTD window is unusual among timing-based learning rules and causes EPSPs that are uncorrelated with postsynaptic APs to become depressed. This behavior suggests a simple model for depression of deprived sensory responses in S1 and V1. PMID:10939330

Feldman, D E

2000-07-01

130

Interaction between gold (III) chloride and potassium hexacyanoferrate (II\\/III)—Does it lead to gold analogue of Prussian blue?  

Microsoft Academic Search

Prussian blue analogues are a class of compounds formed by the reaction between metal salt and potassium hexacyanoferrate (II\\/III). In our earlier report, the formation of Au@Prussian blue nano-composite was noticed on potential cycling the glassy carbon electrode in a medium containing gold (III) chloride and potassium hexacyanoferrate (III). Hence in this work, the formation of gold hexacyanoferrate was attempted

S. Harish; James Joseph; K. L. N. Phani

2011-01-01

131

Modeling the relationship between progression-free survival and overall survival: the phase II/III trial.  

PubMed

The standard phase II trial design has changed dramatically over the past decade. Randomized phase II studies have essentially become the standard phase II design in oncology for a variety of reasons. The use of these designs is motivated by concerns about the use of historical data to determine if a new agent or regimen shows promise of activity. However, randomized phase II designs come with the cost of increased study duration and patient resources. Progression-free survival (PFS) is an important endpoint used in many phase II designs. In many clinical settings, changes in PFS with the introduction of a new treatment may represent true benefit in terms of the gold standard outcome, overall survival (OS). The phase II/III design has been proposed as an approach to shorten the time of discovery of an active regimen. In this article, design considerations for a phase II/III trial are discussed and presented in terms of a model defining the relationship between OS and PFS. The design is also evaluated using 15 phase III trials completed in the Southwest Oncology Group (SWOG) between 1990 and 2005. The model provides a framework to evaluate the validity and properties of using a phase II/III design. In the evaluation of SWOG trials, three of four positive studies would have also proceeded to the final analysis and 10 of 11 negative studies would have stopped at the phase II analysis if a phase II/III design had been used. Through careful consideration and thorough evaluation of design properties, substantial gains could occur using this approach. PMID:23669424

Redman, Mary W; Goldman, Bryan H; LeBlanc, Michael; Schott, Anne; Baker, Laurence H

2013-05-15

132

Methodological quality of animal studies of neuroprotective agents currently in phase II\\/III acute ischemic stroke trials  

Microsoft Academic Search

BACKGROUND AND PURPOSE: Numerous neuroprotective agents have proven effective in animal stroke studies, but every drug has failed to achieve its primary outcome when brought forward to clinical trials. We analyzed the quality and adequacy of animal studies supporting the efficacy of NXY-059 and other neuroprotective agents that are currently being investigated in phase II\\/III trials.\\u000aMETHODS: We conducted a

Maria Philip; Michael Benatar; Marc Fisher; Sean I. Savitz

2008-01-01

133

Methodological Quality of Animal Studies of Neuroprotective Agents Currently in Phase II\\/III Acute Ischemic Stroke Trials  

Microsoft Academic Search

Background and Purpose—Numerous neuroprotective agents have proven effective in animal stroke studies, but every drug has failed to achieve its primary outcome when brought forward to clinical trials. We analyzed the quality and adequacy of animal studies supporting the efficacy of NXY-059 and other neuroprotective agents that are currently being investigated in phase II\\/III trials. Methods—We conducted a systematic search

Maria Philip; Michael Benatar; Marc Fisher; Sean I. Savitz

2011-01-01

134

Esophageal perforations masked by steroids  

Microsoft Academic Search

Esophageal perforation is usually an acute, life-threatening event, and its diagnosis can be established on the basis of obvious clinical and radiographic findings. This article describes two cases whereby symptoms of esophageal perforations were masked by concomitant administration of steroids, thus causing marked delay in diagnosis and treatment. Esophageal rupture should be considered when patients receiving steroids develop unexplained fever

Linas M. Klygis; Rome Jutabha; Michael B. McCrohan; Arvydas D. Vanagunas

1993-01-01

135

Does surgery improve outcomes for esophageal squamous cell carcinoma? An analysis using the Surveillance Epidemiology, and End Results Registry from 1998 to 2008  

PubMed Central

Background We examined survival associated with locally advanced esophageal squamous cell cancer (SCC) to evaluate if treatment without surgery could be considered adequate. Study design Patients in the SEER registry with stage II–III SCC of the mid or distal esophagus from 1998–2008 were grouped by treatment with definitive radiation versus esophagectomy with or without radiation. Information on chemotherapy is not recorded in SEER. Tumor stage was defined as first clinical tumor stage in case of neo-adjuvant therapy and pathological report if no neo-adjuvant therapy was performed. Cancer specific (CSS) and overall survival (OS) were analyzed using the Kaplan-Meier approach and propensity-score adjusted Cox proportional hazard models. Results Of the 2,431 patients analyzed, there were 844 stage IIA (34.7%), 428 stage IIB (17.6%), 1,159 stage III (47.7%) patients. Most were treated with definitive radiation (n=1,426, 58.7%). Of the 1,005 (41.3%) patients who underwent surgery, 369 (36.7%) had preoperative radiation, 160 (15.9%) had postoperative radiation, and 476 (47.4%) had no radiation. Five-year survival was 17.9% for all patients, and 22.1%, 18.5%, and 14.5% for stages IIA, IIB, and stage III, respectively. Compared to treatment that included surgery, definitive radiation alone predicted worse propensity-score adjusted survival for all patients (CSS Hazard Ratio (HR) 1.48, p<0.001; OS HR 1.46, p<0.001) and for stage IIA, IIB, and III patients individually (all p-values ?0.01). Compared to surgery alone, surgery with radiation predicted improved survival for stage III patients (CSS HR 0.62, p=0.001, OS HR 0.62, p<0.001) but not stage IIA or IIB (all p-values>0.18). Conclusions Esophagectomy is associated with improved survival for patients with locally advanced SCC and should be considered as an integral component of the treatment algorithm if feasible.

Worni, Mathias; Martin, Jeremiah; Gloor, Beat; Pietrobon, Ricardo; D'Amico, Thomas A.; Akushevich, Igor; Berry, Mark F.

2012-01-01

136

A Cost and Benefit Study of Esophagectomy for Patients with Esophageal Cancer  

Microsoft Academic Search

Introduction  The incidence of esophageal cancer is increasing all over the world but the cost-and-benefit of esophagectomy for esophageal\\u000a cancer patients was rarely studied. The aim of this study is to compare the cost-and-benefit of esophagectomy in different\\u000a stages of esophageal cancer.\\u000a \\u000a \\u000a \\u000a Materials and Methods  Clinical and utilization data, including medical expenses and reason for treatment, of esophageal cancer patients were collected,

Chih-Cheng Hsieh; Ching-Wen Chien

2009-01-01

137

A Review of the Use of Stents for Palliation of Esophageal and Lung Cancer  

Microsoft Academic Search

According to the American Cancer Society, there will be an estimated 14,520 new cases of esophageal cancer and 174,470 new cases of lung cancer in 2005 (1). Close to 60% of these patients with esophageal cancer will present at an advanced stage not amenable to cure, but still will require palliation of their dysphagia (2). Conventional plastic stents (CPS) were

Costas S. Bizekis; Harvey I. Pass; Michael D. Zervos

2007-01-01

138

CLINICAL RESEARCH • CT and MR imaging for detecting neoplastic invasion of esophageal inlet  

Microsoft Academic Search

AIM: Direct neoplastic invasion of esophageal inlet is an uncommon but significant sequela of advanced head and neck carcinomas. The aim of this study was to seek an optimal CT or MRI criterion for determining the neoplastic esophageal inlet involvement in order to help tumor staging and surgical planning. METHODS: CT and MRI of 78 head and neck tumor cases

Bin Chen; Shan-Kai Yin; Qi-Xin Zhuang; Ying-Sheng Cheng

139

[Advanced esophageal carcinoma recanalization].  

PubMed

Advanced esophageal carcinoma has poor prognosis with 5-year survival of less than 20%. This poor prognosis is the same for squamous cell carcinoma and adenocarcinoma. Surgical therapy, external radiation and chemotherapy with curative intent are usually impossible because of the advanced disease. Dysphagia is the most frequent symptom affecting quality of life. Bougies or balloon dilation improves dysphagia only short-term (few days). Nd-YAG laser, ACP and photodynamic therapy all have mid-range effect and require repetition after few weeks. Brachytherapy and esophageal self-expanding stent insertion have longer benefit. Stent insertion provides fastest improvement of dysphagia; however, complications in later setting occur in30% and require further endoscopic treatment. Brachytherapy has slower onset of benefit but has fewer complications and longer benefit. Brachytherapy is suitable for patients wit expected lifespan more than 3 months. Most important contraindication of brachytherapy is tracheo-esophageal fistula. PMID:19202963

Molnárová, A

2008-01-01

140

Esophageal Perforation in Adults  

PubMed Central

Objective: To evaluate the outcome of aggressive conservative therapy in patients with esophageal perforation. Summary Background Data: The treatment of esophageal perforation remains controversial with a bias toward early primary repair, resection, and/or proximal diversion. This review evaluates an alternate approach with a bias toward aggressive drainage of fluid collections and frequent CT and gastographin UGI examinations to evaluate progress. Methods: From 1992 to 2004, 47 patients with esophageal perforation (10 proximal, 37 thoracic) were treated (18 patients early [<24 hours], 29 late). There were 31 male and 16 females (ages 18–90 years). The etiology was iatrogenic (25), spontaneous (14), trauma (3), dissecting thoracic aneurysm (3), and 1 each following a Stretta procedure and Blakemore tube placement. Results: Six of 10 cervical perforations underwent surgery (3 primary repair, 3 abscess drainage). Nine of 10 perforations healed at discharge. In 37 thoracic perforations, 2 underwent primary repair (1 iatrogenic, 1 spontaneous) and 4 underwent limited thoracotomy. Thirty-4 patients (4 cervical, 28 thoracic) underwent nonoperative treatment. Thirteen of the 14 patients with spontaneous perforation (thoracic) underwent initial nonoperative care. Overall mortality was 4.2% (2 of 47 patients). These deaths represent 2 of 37 thoracic perforations (5.4%). There were no deaths in the 34 patients treated nonoperatively. Esophageal healing occurred in 43 of 45 surviving patients (96%). Subsequent operations included colon interposition in 2, esophagectomy for malignancy in 3, and esophagectomy for benign stricture in 2. Conclusions: Aggressive treatment of sepsis and control of esophageal leaks leak lowers mortality and morbidity, allow esophageal healing, and avoid major surgery in most patients.

Vogel, Stephen B.; Rout, W Robert; Martin, Tomas D.; Abbitt, Patricia L.

2005-01-01

141

Hitting Two Birds with One Stone: Crystal Containing Both Disproportionation Products of the Mixed-Valence Ruthenium(II, III) Carboxylate  

Microsoft Academic Search

The disproportionation of the mixed-valence diruthenium(II, III) trifluoroacetate, [Ru2(O2CCF3)5] (1), is reported. The overall conversion leads to the triruthenium(II, III, III) and diruthenium(II, II) species according to the scheme: 4 Ru25+? 2 Ru38+ + Ru24+. Both disproportionation products have been isolated and structurally characterized as they cocrystallize in a 2:1 ratio in the form of the acetone adducts to give

Evgeny V. Dikarev; Bo Li

2004-01-01

142

Causes, evaluation, and consequences of eosinophilic esophagitis.  

PubMed

This paper presents commentaries on whether eosinophilic esophagitis is a food allergy; inflammation in the context of eosinophilic esophagitis; whether eosinophilic esophagitis a cause of noncardiac chest pain; the role of endoscopy in the evaluation of eosinophilic esophagitis; and whether response to proton pump inhibitor therapy can distinguish eosinophilic esophagitis from gastroesophageal reflux disease. PMID:24117638

Chehade, Mirna; Lucendo, Alfredo J; Achem, Sami R; Souza, Rhonda F

2013-10-01

143

Clinical Value of Esophageal Motility Testing  

Microsoft Academic Search

Esophageal motility testing is the method of choice in evaluating esophageal motor disorders. Some physicians, however, question the clinical utility of esophageal motility testing, since the results are often normal in symptomatic patients. The clinical utility of esophageal motility testing is reviewed for patients with a complaint of noncardiac chest pain, dysphagia or symptoms of gastroesophageal reflux disease. Esophageal motility

Melvin L. Allen; Richard B. Lynn; Saeed Zamani

1998-01-01

144

Structure and magnetism of decanuclear and octadecanuclear manganese(II/III) triethanolamine clusters.  

PubMed

Two new potential single molecule magnets [Mn(10)O(3)(O(2)CCH(3))(6)(tea)(teaH)(3)(teaH(2))(3)][NO(3)](2).3H(2)O (1) and [Mn(18)(N(3))(12)O(12)(tea)(2)(teaH)(4)(OMe)(MeOH)].2MeOH.H(2)O.Et(2)O (2) have been synthesised using manganese(II) nitrate, the tripodal ligand triethanolamine (teaH(3)) and co-ligands such as acetate for 1 and azide for 2. Both compounds are mixed-valent with 1 consisting of 4 Mn(II) and 6 Mn(III) ions and 2 consisting of 3 Mn(II) and 15 Mn(III) ions. Complex 1 has a near planar Mn(7)(II/III) disc-like core with 3 Mn(II) ions positioned on the periphery of the disc, forming a star-like geometry. Complex 2 contains a hexa-capped truncated tetrahedral core. Variable temperature DC magnetic susceptibility data collected in 2, 1, 0.1 and 0.01 T fields, and in the 2-300 K temperature range, for 1 and 2, indicate a large ground spin-state for both compounds. Using a new approach to calculating the DC Mvs. H isotherms (or isofield Mvs. H/T curves) by means of the thermal population of Zeeman levels generated from a group of closely spaced S states (within 9 cm(-1) of ground), the ground S of 1 is 10. The ZFS term, D, is close to zero. For 2 , the magnetisation isotherms, and low temperature susceptibilities, point to a ground state spin of (21)/(2) with many closely spaced spin states (probably from (17)/(2) to (35)/(2)) close in energy, the lowest Zeeman level energies of which change as the field increases. AC magnetic susceptibility data show frequency-dependent out-of-phase signals indicating both clusters are possibly single molecule magnets. Extrapolation of the in-phase component, chi'(M)T, to 0 K suggests spin ground state of S = 10 for 1 and (21)/(2) for 2 , in agreement with the DC data. PMID:19173080

Langley, Stuart K; Berry, Kevin J; Moubaraki, Boujemaa; Murray, Keith S

2008-12-12

145

Recurrent spontaneous esophageal rupture  

Microsoft Academic Search

Spontaneous esophageal rupture is an uncommon and poorly understood condition. Recurrent rupture is extremely rare, with only one previously reported case in the literature. Here, we present a case series of two patients who had recurrent ruptures, and discuss the principles underlying the management of such cases.

Omar A. Khan; Clifford W. Barlow; David F. Weeden; Khalid M. Amer

2005-01-01

146

Wrestling and herpetic esophagitis.  

PubMed

Herpes simplex virus esophagitis has rarely been reported in immunocompetent children. We describe 2 immunocompetent wrestlers on the same team who presented with fever, odynophagia, and dysphagia. Histologic examination of the esophagus showed ulceration and exudate, herpes simplex virus was detected by polymerase chain reaction. We propose that wrestling may be a mode of transmission for this disease. PMID:21544004

Khlevner, Julie; Beneri, Christy; Morganstern, Jeffrey A

2011-10-01

147

Esophageal Rings and Webs  

MedlinePLUS

... determine if you have a ring or a web, your doctor may order one of these tests: Barium swallow test. This allows the radiologist to ... contribute to the development of esophageal rings and webs, your doctor probably will order a blood test for iron levels and, if you are deficient, ...

148

Curative Resection for Esophageal Adenocarcinoma  

PubMed Central

Objective To document what can be accomplished with surgical resection done according to the classical principles of surgical oncology. Methods One hundred consecutive patients underwent en bloc esophagectomy for esophageal adenocarcinoma. No patient received pre- or postoperative chemotherapy or radiation therapy. Tumor depth and number and location of involved lymph nodes were recorded. A lymph node ratio was calculated by dividing the number of involved nodes by the total number removed. Follow-up was complete in all patients. The median follow-up of surviving patients was 40 months, with 23 patients surviving 5 years or more. Results The overall actuarial survival rate at 5 years was 52%. Survival rates by American Joint Commission on Cancer (AJCC) stage were stage 1 (n = 26), 94%; stage 2a (n = 11), 65%; stage 2b (n = 13), 65%; stage 3 (n = 32), 23%; and stage 4 (n = 18), 27%. Sixteen tumors were confined to the mucosa, 16 to the submucosa, and 13 to the muscularis propria, and 55 were transmural. Tumor depth and the number and ratio of involved nodes were predictors of survival. Metastases to celiac (n = 16) or other distant node sites (n = 26) were not associated with decreased survival. Local recurrence was seen in only one patient. Latent nodal recurrence outside the surgical field occurred in 9 patients and systemic metastases in 31. Tumor depth, the number of involved nodes, and the lymph node ratio were important predictors of systemic recurrence. The surgical death rate was 6%. Conclusion Long-term survival from adenocarcinoma of the esophagus can be achieved in more than half the patients who undergo en bloc resection. One third of patients with lymph node involvement survived 5 years. Local control is excellent after en bloc resection. The extent of disease associated with tumors confined to the mucosa and submucosa provides justification for more limited and less morbid resections.

Hagen, Jeffrey A.; DeMeester, Steven R.; Peters, Jeffrey H.; Chandrasoma, Para; DeMeester, Tom R.

2001-01-01

149

Esophageal dysfunction in esophagopharyngeal regurgitation.  

PubMed

Esophageal manometry was performed in 20 patients with esophagopharyngeal regurgitation, in 20 patients with severe chronic heartburn but without regurgitation, and in 20 normal subjects. The purpose of the procedure was to identify possible differences between these groups in upper esophageal sphincter and lower esophageal sphincter resting pressures, and in amplitude of peristaltic contraction in the distal esophagus. The mean peak upper esophageal sphincter pressures in normal subjects and in patients with chronic heartburn were significantly greater than in the patients with esophagopharyngeal regurgitation (101 and 108 vs. 54 mmHg, respectively). In the normal subjects, the mean lower esophageal sphincter resting pressure (19 mmHg) was significantly greater than for the heartburn group (14 mmHg) and for the patients with esophagopharyngeal regurgitation (10 mmHg). The amplitude of peristalsis was significantly lower in the group with regurgitation than in both normal subjects and the group with chronic heartburn. Nine normal subjects responded to intraesophageal infusion of 0.9% NaCl and 0.1 N HCl with a significant increase in upper esophageal sphincter resting pressure, but the group with esophagopharyngeal regurgitation showed no significant change. Patients with esophagopharyngeal regurgitation have lower esophageal sphincter hypotension, diminished peristaltic amplitude, upper esophageal sphincter hypotension, and diminished upper esophageal sphincter response to intraesophageal fluid. We conclude there is in these patients a breakdown of several normal esophageal mechanisms which ordinarily serve as barriers to esophagopharyngeal regurgitation. PMID:7053042

Gerhardt, D C; Castell, D O; Winship, D H; Shuck, T J

1980-05-01

150

Inhibiting Interleukin-19 Activity Ameliorates Esophageal Squamous Cell Carcinoma Progression  

PubMed Central

Background IL-19 is expressed in esophageal squamous cell carcinoma (SCC), but its biological effect on esophageal cancer remains unclear. We determined the correlation between IL-19 expression levels and clinicopathological variables and explored the effects of IL-19 on the esophageal SCC in vivo and in vitro. Methodology/Principal Findings We determined the expression levels of esophageal SCC tissues from 60 patients using immunohistochemistry. We examined the effects of IL-19 on intracellular signaling, cytokines production as well as proliferation, colonization, and migration in the human esophageal SCC cell line CE81T. Monoclonal antibodies (mAbs) against IL-19 (1BB1) and its receptor IL-20R1 (51D) were used to antagonize the effects of IL-19. We injected SCID mice with CE81T cells and then treated them with anti-IL-19 mAb or control IgG every 3 days and determined tumor growth for 32 days. Of the 60 esophageal SCC patients, 36 patients (60%) were IL-19 strongly stained, which was associated with advanced tumor stage. CE81T cells expressed IL-19 and its receptors. IL-19 induced phosphorylation of STAT3, P38, JNK, ERK1/2, Akt, and NF-?B in CE81T cells. IL-19 promoted the proliferation, colonization, and migration of CE81T cells, which were antagonized by 1BB1 and 51D. IL-19 also induced expression of the transcripts of TGF-?, cyclin B1, CXCR4, and MMP-1 in CE81T cells. In CE81T tumor-bearing mice, 1BB1 reduced tumor growth and downregulated TGF-?, cyclin B1, MMP-1, and CXCR4 expression in tumors. Conclusions/Significance IL-19 affects the pathogenesis of esophageal cancer. IL-19 mAb (1BB1) is potentially a potent drug for esophageal cancer therapy.

Cheng, Hung-Chi; Li, Chien-Feng; Chang, Ming-Shi

2013-01-01

151

21 CFR 878.3610 - Esophageal prosthesis.  

Code of Federal Regulations, 2010 CFR

...Devices § 878.3610 Esophageal prosthesis. (a) Identification. An esophageal prosthesis is a rigid, flexible, or expandable tubular device made of a...esophagus. The metal esophageal prosthesis may be uncovered or...

2009-04-01

152

21 CFR 878.3610 - Esophageal prosthesis.  

Code of Federal Regulations, 2010 CFR

...Devices § 878.3610 Esophageal prosthesis. (a) Identification. An esophageal prosthesis is a rigid, flexible, or expandable tubular device made of a...esophagus. The metal esophageal prosthesis may be uncovered or...

2010-04-01

153

Formation of ‘ferric green rust’ and\\/or ferrihydrite by fast oxidation of iron(II–III) hydroxychloride green rust  

Microsoft Academic Search

Fast oxidation processes of iron(II–III) hydroxychloride green rust GR(Cl?), FeII3FeIII(OH)8Cl·2H2O, were simulated by two different methods. The first one consisted in using a strong oxidiser, namely H2O2. The main end product, analysed by X-ray diffraction and Mössbauer spectroscopy, is an iron(III) compound, designated as “ferric GR(Cl?)”, characterised by a layered structure identical to that of normal GR(Cl?). The second method

Ph. Refait; O. Benali; M. Abdelmoula; J.-M. R. Génin

2003-01-01

154

Coprecipitation thermodynamics of iron(II–III) hydroxysulphate green rust from Fe(II) and Fe(III) salts  

Microsoft Academic Search

Iron(II–III) hydroxysulphate GR(SO42?) was prepared by precipitating a mixture of Fe(II) and Fe(III) sulphate solutions with NaOH, accompanied in most cases by iron(II) hydroxide, spinel iron oxide(s) or goethite. Its [Fe(II)]\\/[Fe(III)] ratio determined by transmission Mössbauer spectroscopy was 2±0.2, whatever the initial [Fe(II)]\\/[Fe(III)] ratio in solution. Proportion of Fe(OH)2 increased when the initial [Fe(II)]\\/[Fe(III)] ratio increased, whereas proportion of ?-FeOOH

Ph Refait; A Géhin; M Abdelmoula; J.-M. R Génin

2003-01-01

155

Esophageal pain: Emerging concepts  

Microsoft Academic Search

Esophageal pain manifests as symptoms of heartburn, chest pain, or both. It shares features with other types of visceral pain\\u000a in that it is poorly characterized and not well localized, owing to the divergence of visceral afferents. The esophagus is\\u000a innervated by vagal and visceral spinal afferents, both of which are activated by noxious stimuli and convey information to\\u000a specific

Robert Lee; Ravinder K. Mittal

2007-01-01

156

Erosion of an esophageal endoprosthesis into the trachea.  

PubMed

Acquired benign non-neoplastic tracheoesophageal fistulas are unusual, demanding clinical entities. Surgical technique and final outcome depends on fistula size. A one-stage procedure with esophageal resection is preferred when the fistula is located in the upper third of the trachea and is less than 1 cm long. PMID:17126153

Rampado, Sabrina; Battaglia, Giorgio; Zaninotto, Giovanni; Ruol, Alberto; Portale, Giuseppe; Ancona, Ermanno

2006-12-01

157

Patterns of lymphatic drainage and lymph node involvement in esophageal cancer.  

PubMed

The esophagus has a complex pattern of lymphatic drainage. Lymph node involvement and number of lymph node metastases are very important prognostic factors, and the newly revised TNM staging system for esophageal cancer reflects this. Knowledge of the location and nomenclature of the common nodal stations in the thorax and upper abdomen is essential for the accurate staging of these patients. PET-CT and EUS are essential in the routine staging of esophageal cancer patients. The aim of this pictorial review is to present the nodal stations, nomenclature and location of regional lymph nodes in esophageal cancer using PET-CT and EUS images from selected patient cases. We will review the EUS and PET-CT imaging for a number of patients with esophageal cancer, using cases which highlight the advantages and diagnostic pitfalls for these imaging modalities. PMID:22711183

Howard, J M; Johnston, C

2013-04-01

158

New treatments, new challenges: pathology's perspective on esophageal carcinoma.  

PubMed

While frank esophageal carcinoma rarely presents a diagnostic challenge, early lesions are often tricky to assess. This difficulty stems in part from drawbacks in the classification systems designed to stratify early lesions as a guide for deciding treatment. These systems are complex and wrought with specific pathologic challenges brought on by new treatment modalities. Such interventions as endoscopic mucosal resection, photodynamic therapy, and chemotherapy/radiation combinations present the pathologist with new histologic challenges that have a direct impact on patient care. In this article, we discuss staging issues pertinent to early cancers, histologic sequelae of various treatments, and how these factors affect the pathologist's role in evaluating esophageal carcinoma. PMID:19327571

Scudiere, Jennifer R; Montgomery, Elizabeth A

2009-03-01

159

1H-NMR based metabonomic profiling of human esophageal cancer tissue  

PubMed Central

Background The biomarker identification of human esophageal cancer is critical for its early diagnosis and therapeutic approaches that will significantly improve patient survival. Specially, those that involves in progression of disease would be helpful to mechanism research. Methods In the present study, we investigated the distinguishing metabolites in human esophageal cancer tissues (n?=?89) and normal esophageal mucosae (n?=?26) using a 1H nuclear magnetic resonance (1H-NMR) based assay, which is a highly sensitive and non-destructive method for biomarker identification in biological systems. Principal component analysis (PCA), partial least squares-discriminant analysis (PLS-DA) and orthogonal partial least-squares-discriminant anlaysis (OPLS-DA) were applied to analyse 1H-NMR profiling data to identify potential biomarkers. Results The constructed OPLS-DA model achieved an excellent separation of the esophageal cancer tissues and normal mucosae. Excellent separation was obtained between the different stages of esophageal cancer tissues (stage II?=?28; stage III?=?45 and stage IV?=?16) and normal mucosae. A total of 45 metabolites were identified, and 12 of them were closely correlated with the stage of esophageal cancer. The downregulation of glucose, AMP and NAD, upregulation of formate indicated the large energy requirement due to accelerated cell proliferation in esophageal cancer. The increases in acetate, short-chain fatty acid and GABA in esophageal cancer tissue revealed the activation of fatty acids metabolism, which could satisfy the need for cellular membrane formation. Other modified metabolites were involved in choline metabolic pathway, including creatinine, creatine, DMG, DMA and TMA. These 12 metabolites, which are involved in energy, fatty acids and choline metabolism, may be associated with the progression of human esophageal cancer. Conclusion Our findings firstly identify the distinguishing metabolites in different stages of esophageal cancer tissues, indicating the attribution of metabolites disturbance to the progression of esophageal cancer. The potential biomarkers provide a promising molecular diagnostic approach for clinical diagnosis of human esophageal cancer and a new direction for the mechanism study.

2013-01-01

160

Molecular aspects of esophageal development.  

PubMed

The following on molecular aspects of esophageal development contains commentaries on esophageal striated myogenesis and transdifferentiation; conversion from columnar into stratified squamous epithelium in the mouse esophagus; the roles for BMP signaling in the developing esophagus and forestomach; and evidence of a direct conversion from columnar to stratified squamous cells in the developing esophagus. PMID:21950820

Rishniw, Mark; Rodriguez, Pavel; Que, Jianwen; Burke, Zoe D; Tosh, David; Chen, Hao; Chen, Xiaoxin

2011-09-01

161

Molecular aspects of esophageal development  

PubMed Central

The following on molecular aspects of esophageal development contains commentaries on esophageal striated myogenesis and transdifferentiation; conversion from columnar into stratified squamous epithelium in the mouse esophagus; the roles for BMP signaling in the developing esophagus and forestomach; and evidence of a direct conversion from columnar to stratified squamous cells in the developing esophagus.

Rishniw, Mark; Rodriguez, Pavel; Que, Jianwen; Burke, Zoe D.; Tosh, David; Chen, Hao; Chen, Xiaoxin

2013-01-01

162

Pill-induced esophageal injury  

Microsoft Academic Search

We report four cases of esophageal injury associated with the ingestion of commonly prescribed tablets or capsules. History and clinical characteristics of these cases suggest that the medications failed to transit the esophagus and acted locally to produce esophagitis. A search of English- and foreign-language medical journals documented 221 similar cases due to 26 different types of medication. While most

James Walter Kikendall; Arnold C. Friedman; Morakinyo Anthony Oyewole; David Fleischer; Lawrence F. Johnson

1983-01-01

163

21 CFR 868.1920 - Esophageal stethoscope with electrical conductors.  

Code of Federal Regulations, 2010 CFR

...Esophageal stethoscope with electrical conductors. 868.1920 Section...Esophageal stethoscope with electrical conductors. (a) Identification...esophageal stethoscope with electrical conductors is a device that...

2009-04-01

164

21 CFR 868.1920 - Esophageal stethoscope with electrical conductors.  

Code of Federal Regulations, 2013 CFR

...Esophageal stethoscope with electrical conductors. 868.1920 Section 868...Esophageal stethoscope with electrical conductors. (a) Identification. An esophageal stethoscope with electrical conductors is a device that is...

2013-04-01

165

Pediatric esophageal leiomyosarcoma: a case report  

Microsoft Academic Search

Esophageal leiomyosarcoma accounts for only 0.5% of all esophageal tumors. This rare tumor has been reported in middle-aged or elderly patients. In contrast, pediatric esophageal leiomyosarcomas have never been reported. The case described herein is the first report of an esophageal leiomyosarcoma in a pediatric patient with its own characteristics. The patient had symptoms of mild cough without dysphagia. The

Wen-xian Wang; Desai Gaurav; Li Wen; Ming-fu Ye; Qing-rong Sun; Wei-jin Liu; Dong Zhang

2011-01-01

166

Porphyrin-sensitized solar cells with cobalt (II/III)-based redox electrolyte exceed 12 percent efficiency.  

PubMed

The iodide/triiodide redox shuttle has limited the efficiencies accessible in dye-sensitized solar cells. Here, we report mesoscopic solar cells that incorporate a Co((II/III))tris(bipyridyl)-based redox electrolyte in conjunction with a custom synthesized donor-?-bridge-acceptor zinc porphyrin dye as sensitizer (designated YD2-o-C8). The specific molecular design of YD2-o-C8 greatly retards the rate of interfacial back electron transfer from the conduction band of the nanocrystalline titanium dioxide film to the oxidized cobalt mediator, which enables attainment of strikingly high photovoltages approaching 1 volt. Because the YD2-o-C8 porphyrin harvests sunlight across the visible spectrum, large photocurrents are generated. Cosensitization of YD2-o-C8 with another organic dye further enhances the performance of the device, leading to a measured power conversion efficiency of 12.3% under simulated air mass 1.5 global sunlight. PMID:22053043

Yella, Aswani; Lee, Hsuan-Wei; Tsao, Hoi Nok; Yi, Chenyi; Chandiran, Aravind Kumar; Nazeeruddin, Md Khaja; Diau, Eric Wei-Guang; Yeh, Chen-Yu; Zakeeruddin, Shaik M; Grätzel, Michael

2011-11-01

167

Oxidation modes and thermodynamics of Fe II-III oxyhydroxycarbonate green rust: Dissolution-precipitation versus in situ deprotonation  

NASA Astrophysics Data System (ADS)

Fe II-III hydroxycarbonate green rust GR(CO 32-), Fe II4 Fe III2 (OH) 12 CO 3·3H 2O, is oxidized in aqueous solutions with varying reaction kinetics. Rapid oxidation with either H 2O 2 or dissolved oxygen under neutral and alkaline conditions leads to the formation of ferric oxyhydroxycarbonate GR(CO 32-)?, Fe III6 O 12 H 8 CO 3·3H 2O, via a solid-state reaction. By decreasing the flow of oxygen bubbled in the solution, goethite ?-FeOOH forms by dissolution-precipitation mechanism whereas a mixture of non-stoichiometric magnetite Fe (3-x)O 4 and goethite is observed for lower oxidation rates. The intermediate Fe II-III oxyhydroxycarbonate of formula Fe II6(1-x) Fe III6x O 12 H 2(7-3x) CO 3·3H 2O, i.e. GR( x)? for which x ? [1/3, 1], is the synthetic compound that is homologous to the fougerite mineral present in hydromorphic gleysol; in situ oxidation accounts for the variation of ferric molar fraction x = [Fe III]/{[Fe II]+[Fe III]} observed in the field as a function of depth and season but limited to the range [1/3, 2/3]. The domain of stability for partially oxidized green rust is observed in the Eh-pH Pourbaix diagrams if thermodynamic properties of GR( x)? is compared with those of lepidocrocite, ?-FeOOH, and goethite, ?-FeOOH. Electrochemical equilibrium between GR( x)? and Fe II in solution corresponds to Eh-pH conditions close to those measured in the field. Therefore, the reductive dissolution of GR( x)? can explain the relatively large concentration of Fe II measured in aqueous medium of hydromorphic soils containing fougerite.

Ruby, Christian; Abdelmoula, Mustapha; Naille, Sébastien; Renard, Aurélien; Khare, Varsha; Ona-Nguema, Georges; Morin, Guillaume; Génin, Jean-Marie R.

2010-02-01

168

Environmental enrichment selectively increases glutamatergic responses in layer II/III of the auditory cortex of the rat  

PubMed Central

Prolonged exposure to environmental enrichment (EE) induces behavioral adaptation accompanied by detectable morphological and physiological changes. Auditory EE is associated with an increased auditory evoked potential (AEP) and increased auditory gating in the primary auditory cortex. We sought physiological correlates to such changes by comparing synaptic currents in control vs. EE-raised rats, in a primary auditory cortex (AI) slice preparation. Pharmacologically isolated glutamatergic or ?-amino-butyric acid-A (GABAA-) receptor-mediated currents were measured using perforated patch whole-cell recordings. Glutamatergic alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid-receptor- (AMPAR-) mediated postsynaptic currents (EPSCs) displayed a large amplitude increase (64.2 ± 11.6 % in EE vs. control) accompanied by a rise-time decrease (?29.24 ± 5.7 % in EE vs. control) and decrease in pair pulse ratio in layer II/III but not in layer V. Changes in glutamatergic signaling were not associated with changes in the ratio between N-methyl-D aspartate-receptor-(NMDAR-) mediated vs. AMPAR- mediated components, in amplitude or pair pulse ratio of GABAergic transmission, or in passive neuronal properties. A realistic computational model was used for integrating in vivo and in vitro results, and for determining how EE synapses correct for phase error of the inputs. We found that EE not only increases the mean firing frequency of the responses, but also improves the robustness of auditory processing by decreasing the dependence of the output firing on the phase difference of the input signals. We conclude that behavioral and electrophysiological differences detected in vivo in rats exposed to an auditory EE are accompanied and possibly caused by selective changes in cortical excitatory transmission. Our data suggest that auditory EE selectively enhances excitatory glutamatergic synaptic transmission in layer II/III without greatly altering inhibitory GABAergic transmission.

Nichols, Justin; Jakkamsetti, Vikram; Salgado, Humberto; Dinh, Lu; Kilgard, Michael; Atzori, Marco

2007-01-01

169

Psychiatric illness delays diagnosis of esophageal cancer  

PubMed Central

SUMMARY Evidence suggests that patients with psychiatric illnesses may be more likely to experience a delay in diagnosis of coexisting cancer. The association between psychiatric illness and timely diagnosis and survival in patients with esophageal cancer has not been studied. The specific aim of this retrospective cohort study was to determine the impact of coexisting psychiatric illness on time to diagnosis, disease stage and survival in patients with esophageal cancer. All patients with a diagnosis of esophageal cancer between 1989 and 2003 at the Portland Veteran’s Administration hospital were identified by ICD-9 code. One hundred and sixty patients were identified: 52 patients had one or more DSM-IV diagnoses, and 108 patients had no DSM-IV diagnosis. Electronic charts were reviewed beginning from the first recorded encounter for all patients and clinical and demographic data were collected. The association between psychiatric illness and time to diagnosis of esophageal cancer and survival was studied using Cox proportional hazard models. Groups were similar in age, ethnicity, body mass index, and history of tobacco and alcohol use. Psychiatric illness was associated with delayed diagnosis (median time from alarm symptoms to diagnosis 90 days vs. 35 days in patients with and without psychiatric illness, respectively, P < 0.001) and the presence of advanced disease at the time of diagnosis (37% vs. 18% of patients with and without psychiatric illness, respectively, P = 0.009). In multivariate analysis, psychiatric illness and depression were independent predictors for delayed diagnosis (hazard ratios 0.605 and 0.622, respectively, hazard ratio < 1 indicating longer time to diagnosis). Dementia was an independent risk factor for worse survival (hazard ratio 2.984). Finally, psychiatric illness was associated with a decreased likelihood of receiving surgical therapy. Psychiatric illness is a risk factor for delayed diagnosis, a diagnosis of advanced cancer, and a lower likelihood of receiving surgical therapy in patients with esophageal cancer. Dementia is associated with worse survival in these patients. These findings emphasize the importance of prompt evaluation of foregut symptoms in patients with psychiatric illness.

O'Rourke, R. W.; Diggs, B. S.; Spight, D. H.; Robinson, J.; Elder, K. A.; Andrus, J.; Thomas, C. R.; Hunter, J. G.; Jobe, B. A.

2008-01-01

170

Hyperfine structure in 167Er I+II+III: multiconfiguration Dirac-Fock interpretation of measurements  

Microsoft Academic Search

The authors report the first high-resolution measurement of hyperfine structure (HFS) in the 4f12 configuration of 167Er III. Together with recent measurements of HFS in the 4f126s2 configuration of 167Er I and in the 4f126s configuration of 167Er II, these data constitute the first detailed description of HFS along several ionisation stages in a rare-earth element. Based on ab initio,

U. Nielsen; L.-U. Aaen Andersen; O. Poulsen; E. Riis

1987-01-01

171

Epidemiology of esophageal atresia.  

PubMed

Esophageal atresia (EA) is a rare congenital malformation consisting of a lack of continuity between the upper and lower esophageal pouches, frequently associated with tracheoesophageal fistula. The prevalence of such rare abnormalities is established by global birth surveillance programs over the world. EUROCAT is a European program covering 1.7 million births since its creation. The prevalence of EA in Europe seems stable over decades. The National Birth Defects Prevention Network in the USA also shows a stable prevalence with a wide range between states or regions. In France, with the implementation of the national rare diseases plan, a reference center for congenital abnormalities of the esophagus was created in 2006 and a national registry for EA began patient inclusion in 2008. This has resulted in the establishment of the national live birth prevalence for EA, prenatal diagnosis rates, and clinical characteristics of EA patients, early survival, and early morbidity. Prevalence rates seem stable all over the world since many decades. Continuous surveillance of congenital abnormalities and specific registries are useful for epidemiologic data but also for public health authorities for helping families of rare diseases patients. PMID:23679022

Sfeir, R; Michaud, L; Salleron, J; Gottrand, F

172

Treatment of advanced esophageal cancer  

SciTech Connect

When radiation therapy is used for palliation of obstruction in patients with advanced esophageal carcinoma, an improvement in dysphagia can be expected in approximately 50% of patients. Major objective responses have rarely been quantitied but, in one study, were seen in 33% patients. Recurrence of dysphagia is usually seen within 2-6 months of treatment. Radiation toxicities and complications, even when used with palliative intent, can be substantial and include esophagitis, tracheoesophageal or esophageal-aortic fistula, mediastinitis, hemorrhage, pneumonitis, and myelosuppression. (JMT)

Kelsen, D.

1982-12-01

173

Nuclear medicine and esophageal surgery  

SciTech Connect

The principal radionuclide procedures involved in the evaluation of esophageal disorders that are amenable to surgery are illustrated and briefly described. The role of the radionuclide esophagogram (RE) in the diagnosis and management of achalasia, oculopharyngeal muscular dystrophy and its complications, tracheoesophageal fistulae, pharyngeal and esophageal diverticulae, gastric transposition, and fundoplication is discussed. Detection of columnar-lined esophagus by Tc-99m pertechnetate imaging and of esophageal carcinoma by Ga-67 citrate and Tc-99m glucoheptonate studies also is presented. 37 references.

Taillefer, R.; Beauchamp, G.; Duranceau, A.C.; Lafontaine, E.

1986-06-01

174

Use of Preclinical Data for Selection of a Phase II\\/III Dose for Evernimicin and Identification of a Preclinical MIC Breakpoint  

Microsoft Academic Search

One of the most challenging issues in the design of phase II\\/III clinical trials of antimicrobial agents is dose selection. The choice is often based on preclinical data from pharmacokinetic (PK) studies with animals and healthy volunteers but is rarely linked directly to the target organisms except by the MIC, an in vitro measure of antimicrobial activity with many limitations.

G. L. Drusano; S. L. Preston; C. Hardalo; R. Hare; C. Banfield; D. Andes; O. Vesga; W. A. Craig

2001-01-01

175

Esophageal tissue engineering: A new approach for esophageal replacement  

PubMed Central

A number of congenital and acquired disorders require esophageal tissue replacement. Various surgical techniques, such as gastric and colonic interposition, are standards of treatment, but frequently complicated by stenosis and other problems. Regenerative medicine approaches facilitate the use of biological constructs to replace or regenerate normal tissue function. We review the literature of esophageal tissue engineering, discuss its implications, compare the methodologies that have been employed and suggest possible directions for the future. Medline, Embase, the Cochrane Library, National Research Register and ClinicalTrials.gov databases were searched with the following search terms: stem cell and esophagus, esophageal replacement, esophageal tissue engineering, esophageal substitution. Reference lists of papers identified were also examined and experts in this field contacted for further information. All full-text articles in English of all potentially relevant abstracts were reviewed. Tissue engineering has involved acellular scaffolds that were either transplanted with the aim of being repopulated by host cells or seeded prior to transplantation. When acellular scaffolds were used to replace patch and short tubular defects they allowed epithelial and partial muscular migration whereas when employed for long tubular defects the results were poor leading to an increased rate of stenosis and mortality. Stenting has been shown as an effective means to reduce stenotic changes and promote cell migration, whilst omental wrapping to induce vascularization of the construct has an uncertain benefit. Decellularized matrices have been recently suggested as the optimal choice for scaffolds, but smart polymers that will incorporate signalling to promote cell-scaffold interaction may provide a more reproducible and available solution. Results in animal models that have used seeded scaffolds strongly sug- gest that seeding of both muscle and epithelial cells on scaffolds prior to implantation is a prerequisite for complete esophageal replacement. Novel approaches need to be designed to allow for peristalsis and vascularization in the engineered esophagus. Although esophageal tissue engineering potentially offers a real alternative to conventional treatments for severe esophageal disease, important barriers remain that need to be addressed.

Totonelli, Giorgia; Maghsoudlou, Panagiotis; Fishman, Jonathan M; Orlando, Giuseppe; Ansari, Tahera; Sibbons, Paul; Birchall, Martin A; Pierro, Agostino; Eaton, Simon; De Coppi, Paolo

2012-01-01

176

Clinicopathologic characteristics of high expression of Bmi-1 in esophageal adenocarcinoma and squamous cell carcinoma  

PubMed Central

Background High expression of Bmi-1, a key regulatory component of the polycomb repressive complex-1, has been associated with many solid and hematologic malignancies including esophageal squamous cell carcinoma. However, little is known about the role of Bmi-1 in esophageal adenocarcinoma. The aim of this study is to investigate the amplification and high expression of Bmi-1 and the associated clinicopathologic characteristics in esophageal adenocarcinoma and squamous cell carcinoma. Methods The protein expression level of Bmi-1 was detected by immunohistochemistry (IHC) from tissue microarrays (TMA) constructed at the University of Rochester from using tissues accrued between 1997 and 2005. Types of tissues included adenocarcinoma, squamous cell carcinoma and precancerous lesions. Patients’ survival data, demographics, histologic diagnoses and tumor staging data were collected. The intensity (0–3) and percentage of Bmi-1 expression on TMA slides were scored by two pathologists. Genomic DNA from 116 esophageal adenocarcinoma was analyzed for copy number aberrations using Affymetrix SNP 6.0 arrays. Fisher exact tests and Kaplan-Meier methods were used to analyze data. Results By IHC, Bmi-1 was focally expressed in the basal layers of almost all esophageal squamous mucosa, which was similar to previous reports in other organs related to stem cells. High Bmi-1 expression significantly increased from squamous epithelium (7%), columnar cell metaplasia (22%), Barrett’s esophagus (22%), to low- (45%) and high-grade dysplasia (43%) and adenocarcinoma (37%). The expression level of Bmi-1 was significantly associated with esophageal adenocarcinoma differentiation. In esophageal adenocarcinoma, Bmi-1 amplification was detected by DNA microarray in a low percentage (3%). However, high Bmi-1 expression did not show an association with overall survival in both esophageal adenocarcinoma and squamous cell carcinoma. Conclusions This study demonstrates that high expression Bmi-1 is associated with esophageal adenocarcinoma and precancerous lesions, which implies that Bmi-1 plays an important role in early carcinogenesis in esophageal adenocarcinoma.

2012-01-01

177

Spectrum of esophageal disorders in children with chest pain  

Microsoft Academic Search

The charts of 83 children with chest pain who underwent esophageal manometry followed by esophagogastroscopy were reviewed. Forty-seven (57%) had normal esophageal histology and normal motility (group I). Esophagitis and normal motility were demonstrated in 15 children (group II), normal esophageal histology and esophageal dysmotility in 13 (group III), and both esophagitis and abnormal motility in 8 (group IV). Diffuse

Mark S. Glassman; Marvin S. Medow; Stuart Berezin; Leonard J. Newman

1992-01-01

178

Environmental Causes of Esophageal Cancer  

PubMed Central

Synopsis This articles reviews the environmental risk factors and predisposing conditions for the two main histological types of esophageal cancer, esophageal squamous cell carcinoma (ESCC) and esophageal adenocarcinoma (EA). Tobacco smoking, excessive alcohol consumption, drinking maté, low intake of fresh fruits and vegetables, achalasia, and low socioeconomic status increase the risk of ESCC. Results of investigations on several other potential risk factors, including opium consumption, intake of hot drinks, eating pickled vegetables, poor oral health, and exposure to human papillomavirus, polycyclic aromatic hydrocarbons, N-nitroso compounds, acetaldehyde, and fumonisins are also discussed. Gastroesophageal reflux, obesity, tobacco smoking, hiatal hernia, achalasia, and probably absence of H. pylori in the stomach increase the risk of EA. Results of studies investigating other factors, including low intake of fresh fruits and vegetables, consumption of carbonated soft drink, use of H2 blockers, non-steroidal anti-inflammatory drugs, and drugs that relax the lower esophageal sphincter are also discussed.

Kamangar, Farin; Chow, Wong-Ho; Abnet, Christian; Dawsey, Sanford

2009-01-01

179

Hyperfractionated Concomitant Boost Proton Beam Therapy for Esophageal Carcinoma  

SciTech Connect

Purpose: To evaluate the efficacy and safety of hyperfractionated concomitant boost proton beam therapy (PBT) for patients with esophageal cancer. Methods and Materials: The study participants were 19 patients with esophageal cancer who were treated with hyperfractionated photon therapy and PBT between 1990 and 2007. The median total dose was 78 GyE (range, 70-83 GyE) over a median treatment period of 48 days (range, 38-53 days). Ten of the 19 patients were at clinical T Stage 3 or 4. Results: There were no cases in which treatment interruption was required because of radiation-induced esophagitis or hematologic toxicity. The overall 1- and 5-year actuarial survival rates for all 19 patients were 79.0% and 42.8%, respectively, and the median survival time was 31.5 months (95% limits: 16.7- 46.3 months). Of the 19 patients, 17 (89%) showed a complete response within 4 months after completing treatment and 2 (11%) showed a partial response, giving a response rate of 100% (19/19). The 1- and 5-year local control rates for all 19 patients were 93.8% and 84.4 %, respectively. Only 1 patient had late esophageal toxicity of Grade 3 at 6 months after hyperfractionated PBT. There were no other nonhematologic toxicities, including no cases of radiation pneumonia or cardiac failure of Grade 3 or higher. Conclusions: The results suggest that hyperfractionated PBT is safe and effective for patients with esophageal cancer. Further studies are needed to establish the appropriate role and treatment schedule for use of PBT for esophageal cancer.

Mizumoto, Masashi [Proton Medical Research Center, University of Tsukuba, Tsukuba, Ibaraki (Japan); Department of Radiation Oncology, University of Tsukuba, Tsukuba, Ibaraki (Japan); Sugahara, Shinji [Proton Medical Research Center, University of Tsukuba, Tsukuba, Ibaraki (Japan); Department of Radiation Oncology, University of Tsukuba, Tsukuba, Ibaraki (Japan); Tokyo Medical University Ibaraki Medical Center, Ibaraki (Japan); Okumura, Toshiyuki; Hashimoto, Takayuki; Oshiro, Yoshiko; Fukumitsu, Nobuyoshi [Proton Medical Research Center, University of Tsukuba, Tsukuba, Ibaraki (Japan); Department of Radiation Oncology, University of Tsukuba, Tsukuba, Ibaraki (Japan); Nakahara, Akira [Department of Gastroenterological Medicine, University of Tsukuba, Tsukuba, Ibaraki (Japan); Terashima, Hideo [Department of Surgery, University of Tsukuba, Tsukuba, Ibaraki (Japan); Tsuboi, Koji [Proton Medical Research Center, University of Tsukuba, Tsukuba, Ibaraki (Japan); Department of Radiation Oncology, University of Tsukuba, Tsukuba, Ibaraki (Japan); Sakurai, Hideyuki, E-mail: hsakurai@pmrc.tsukuba.ac.jp [Proton Medical Research Center, University of Tsukuba, Tsukuba, Ibaraki (Japan); Department of Radiation Oncology, University of Tsukuba, Tsukuba, Ibaraki (Japan)

2011-11-15

180

Giant asymptomatic primary esophageal schwannoma.  

PubMed

Primary esophageal schwannomas are uncommon. We describe a case of a large asymptomatic primary esophageal schwannoma in a 65-year-old patient. Computed tomography and positron emission tomography revealed an (18)F-fluorodeoxyglucose-avid 11-cm mass arising from the esophagus. A preoperative diagnosis was made via endoscopic ultrasound. The patient underwent a three-field esophagogastrectomy with cervical esophagogastric anastomosis. He remains well and free of recurrence 10 months after treatment. PMID:22450109

Kassis, Edmund S; Bansal, Shelly; Perrino, Carmen; Walker, Jon P; Hitchcock, Charles; Ross, Patrick; Daniel, Vincent C

2012-04-01

181

Esophageal carcinoma and transthoracic echocardiography.  

PubMed

We report a rare case of a patient with esophageal carcinoma diagnosed using transthoracic echocardiography. This examination proved to be useful in the identification of a paracardiac mediastinal mass. Images of the esophageal carcinoma, of the stent in the esophagus, and the bubbles inside the stent generated with the ingestion of a carbonated beverage, have not been previously published. Therefore, we believe our findings may be useful to other echocardiographers. PMID:23834459

Cianciulli, Tomás F; Saccheri, María C; Lax, Jorge A; Bianchi, Ricardo A; Beck, Martín A; Ferreiro, Daniel E

2013-07-09

182

Esophageal malignancy: A growing concern  

PubMed Central

Esophageal cancer is mainly found in Asia and east Africa and is one of the deadliest cancers in the world. However, it has not garnered much attention in the Western world due to its low incidence rate. An increasing amount of data indicate that esophageal cancer, particularly esophageal adenocarcinoma, has been rising by 6-fold annually and is now becoming the fastest growing cancer in the United States. This rise has been associated with the increase of the obese population, as abdominal fat puts extra pressure on the stomach and causes gastroesophageal reflux disease (GERD). Long standing GERD can induce esophagitis and metaplasia and, ultimately, leads to adenocarcinoma. Acid suppression has been the main strategy to treat GERD; however, it has not been proven to control esophageal malignancy effectively. In fact, its side effects have triggered multiple warnings from regulatory agencies. The high mortality and fast growth of esophageal cancer demand more vigorous efforts to look into its deeper mechanisms and come up with better therapeutic options.

Chai, Jianyuan; Jamal, M Mazen

2012-01-01

183

Does FDG-PET Add Information to EUS and CT in the Initial Management of Esophageal Cancer? A Prospective Single Center Study  

Microsoft Academic Search

PURPOSE:There is no algorithm for the initial staging of esophageal cancer that is considered standard of care. This prospective blinded study analyzes the utility of FDG-PET as an adjunct to EUS and CT for the management of patients with esophageal cancer.METHODS:Between December 2003 and October 2006, patients diagnosed with esophageal carcinoma underwent EUS, CT, and FDG-PET at their initial evaluation.

Patrick B. McDonough; David R. Jones; K. R. Shen; Patrick G. Northup; Roman L. Galysh; Alfredo Hernandez; Grace E. White; Michel Kahaleh; Vanessa M. Shami

2008-01-01

184

Black esophagus: Acute esophageal necrosis syndrome  

PubMed Central

Acute esophageal necrosis (AEN), commonly referred to as “black esophagus”, is a rare clinical entity arising from a combination of ischemic insult seen in hemodynamic compromise and low-flow states, corrosive injury from gastric contents in the setting of esophago-gastroparesis and gastric outlet obstruction, and decreased function of mucosal barrier systems and reparative mechanisms present in malnourished and debilitated physical states. AEN may arise in the setting of multiorgan dysfunction, hypoperfusion, vasculopathy, sepsis, diabetic ketoacidosis, alcohol intoxication, gastric volvulus, traumatic transection of the thoracic aorta, thromboembolic phenomena, and malignancy. Clinical presentation is remarkable for upper gastrointestinal bleeding. Notable symptoms may include epigastric/abdominal pain, vomiting, dysphagia, fever, nausea, and syncope. Associated laboratory findings may reflect anemia and leukocytosis. The hallmark of this syndrome is the development of diffuse circumferential black mucosal discoloration in the distal esophagus that may extend proximally to involve variable length of the organ. Classic “black esophagus” abruptly stops at the gastroesophageal junction. Biopsy is recommended but not required for the diagnosis. Histologically, necrotic debris, absence of viable squamous epithelium, and necrosis of esophageal mucosa, with possible involvement of submucosa and muscularis propria, are present. Classification of the disease spectrum is best described by a staging system. Treatment is directed at correcting coexisting clinical conditions, restoring hemodynamic stability, nil-per-os restriction, supportive red blood cell transfusion, and intravenous acid suppression with proton pump inhibitors. Complications include perforation with mediastinal infection/abscess, esophageal stricture and stenosis, superinfection, and death. A high mortality of 32% seen in the setting of AEN syndrome is usually related to the underlying medical co-morbidities and diseases.

Gurvits, Grigoriy E

2010-01-01

185

Vertical lines in distal esophageal mucosa (VLEM): a true endoscopic manifestation of esophagitis in children?  

Microsoft Academic Search

Background: We observed an endoscopic abnormality in a group of children with histological esophagitis. We termed this finding “vertical lines in esophageal mucosa” (VLEM). We examined the relationship between the presence of VLEM and significant histologic changes in esophageal mucosal biopsies. Methods: Between January 1, 1992, and August 31, 1994, the senior author (JFF) performed 255 esophageal biopsies. The procedure

Sandeep K. Gupta; Joseph F. Fitzgerald; Sonny K. F. Chong; Joseph M. Croffie; Margaret H. Collins

1997-01-01

186

Delayed primary reconstruction of esophageal atresia and distal tracheoesophageal fistula in a 471-g infant  

PubMed Central

INTRODUCTION Waterston et al. have classified the risk of morbidity in infants with esophageal atresia and tracheoesophageal fistula. However, few cases of esophageal atresia with distal tracheoesophageal fistula in extremely low birth weights infants have been reported. In such infants, the selection of primary reconstruction or staged repair remains controversial. In the present report, we describe the difficulties of perioperative management of such small infants and discuss how to rescue them. PRESENTATION OF CASE A 471-g female infant was delivered at 28 weeks’ gestation via cesarean section. Esophageal atresia with distal tracheoesophageal fistula was diagnosed. Esophageal banding and gastrostomy were performed via laparotomy on day 1. On day 74, when the infant weighed almost 1000 g, airway management was discontinued. On day 136, endotracheal intubation again became necessary because of respiratory problems, and the esophagus was reconstructed on day 141. Despite this operation, the patient died on day 276 because of continuing respiratory problems. DISCUSSION Esophageal banding is considered an appropriate treatment for respiratory problems in such extremely low weight infants. However, the timing of dissection of the tracheoesophageal fistula after esophageal banding is extremely important. CONCLUSION In the present case, ligation of the tracheoesophageal fistula and esophageal reconstruction should have been performed as soon as possible.

Ito, Keiichi; Ashizuka, Shuichi; Kurobe, Masashi; Ohashi, Shinsuke; Kuwashima, Naruo; Yoshizawa, Joji; Ohki, Takao

2012-01-01

187

Risk Factors for Complications After Esophageal Cancer Resection  

PubMed Central

Objective: To identify risk factors for complications after resection for esophageal or cardia cancer. Summary Background Data: Knowledge of risk factors for complications after esophageal resection for cancer is sparse, and prospective population-based studies are lacking. Methods: A prospective, nationwide, population-based study was conducted in Sweden in April 2, 2001 through December 31, 2003. Details about tumor characteristics and stage, surgical procedures, and complications were collected prospectively from the Swedish Esophageal and Cardia Cancer register. Medical records and specific charts from surgical procedures, histopathology reports, and intensive care units were continuously scrutinized. Multivariable logistic regression analyses were used to estimate relative risks and their 95% confidence intervals. Results: Among 275 patients undergoing surgical resection for esophageal or cardia cancer, 122 (44%) had at least one predefined complication. Operation by low-volume surgeons (<5 operations annually) were followed by more anastomotic leakages than those by surgeons with higher volume (odds ratio, 7.86; 95% confidence interval, 2.13–29.00). Hand-sewn and stapled anastomoses did not differ regarding risk of anastomotic leakage. Among cardia cancer patients, transthoracic approach resulted in more respiratory complications compared with transhiatal (abdominal only) approach (odds ratio, 4.78; 95% confidence interval, 1.66–13.76). Older age, adjuvant oncologic therapy, and higher preoperative bleeding volume nonsignificantly increased the risks of complications, while no influence of sex or tumor stage was found. Conclusions: High-volume esophageal surgeons seem to lower the risk of anastomotic leakage. More large-scale studies are warranted to establish the roles of the other potentially important risk factors suggested in our study.

Viklund, Pernilla; Lindblad, Mats; Lu, Ming; Ye, Weimin; Johansson, Jan; Lagergren, Jesper

2006-01-01

188

21 CFR 868.1910 - Esophageal stethoscope.  

Code of Federal Regulations, 2013 CFR

...Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Diagnostic Devices § 868.1910 Esophageal stethoscope. (a) Identification. An esophageal...

2013-04-01

189

21 CFR 868.5650 - Esophageal obturator.  

Code of Federal Regulations, 2013 CFR

...Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5650 Esophageal obturator. (a) Identification. An esophageal...

2013-04-01

190

Sonographic demonstration of cervical esophageal web.  

PubMed

We report a case of esophageal web demonstrated with sonography in a 45-year-old woman with dysphagia. The esophageal web was incidentally detected as a circumferential hypoechoic membrane on sonograms of the cervical esophagus. PMID:16547989

Rokade, Muktachand Laxman

191

21 CFR 876.5365 - Esophageal dilator.  

Code of Federal Regulations, 2013 CFR

...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Therapeutic Devices § 876.5365 Esophageal dilator. (a) Identification. An esophageal...

2013-04-01

192

Morphology and morphopathology of hypopharyngo-esophageal cancer.  

PubMed

Cervical esophageal cancer and hypopharyngeal cancer represent a major diagnostic issue in early stages, considering the fact that the implication of both cervical esophageal and hypopharyngeal cancers shows a poor prognostic from the very beginning. Positive diagnosis can only be made after histopathological analysis and immunohistochemical analysis in addition. The bioptic material is sampled by rigid endoscopy this being the only viable method of assessing data on the tumor prior to the surgery. As much as 95% of tumors located at this site are epidermoid carcinomas with different staging and characteristics, other types of tumors being adenocarcinomas, lymphomas, etc. Several risk factors influence the biology of this site thus inflicting both cellular and molecular modifications that are the origin of cancer development. PMID:22732792

Popescu, B; Popescu, C R; Grigore, Raluca; Mogoant?, Carmen Aurelia; Ioni??, Elena; Moculescu, C; Berte?teanu, ? V G

2012-01-01

193

One hundred seven consecutive surgical resections for hilar cholangiocarcinoma of Bismuth types II, III, IV between 2001 and 2008.  

PubMed

Many authors at high-volume centers all over the world have reported improved outcomes of hilar cholangiocarcinoma by several aggressive surgical approaches such as extended hepatic resection, combined vascular resection, and hepatopancreaticoduodenectomy in recent years. There has been great progress in the surgical treatment of hilar cholangiocarcinoma with these previous efforts by aggressive hepatobiliary surgeons. In particular, surgical techniques, diagnostic modalities, and perioperative management have been remarkably improved as compared with before. Herein we report the surgical outcome for both hilar cholangiocarcinoma of Bismuth types II, III, and IV and intrahepatic cholangiocarcinoma involving the hepatic duct confluence during the recent 8-year period between 2001 and 2008 at our institution, the Department of General Surgery at Chiba University. From our recent experienced results, it can be concluded that the surgical strategy for hilar cholangiocarcinoma has been improved remarkably, and major surgical hepatectomy can be done with relative safety, and these aggressive surgical approaches, including combined vascular resection, may be warranted for the surgical treatment of hilar cholangiocarcinoma. However, the adoption of new innovative therapeutic approaches might be required for further improvement of surgical outcome of hilar cholangiocarcinoma. PMID:19936600

Miyazaki, Masaru; Kimura, Fumio; Shimizu, Hiroaki; Yoshidome, Hiroyuki; Otuka, Masayuki; Kato, Atushi; Yoshitomi, Hideyuki; Furukawa, Katsunori; Takeuchi, Dan; Takayashiki, Tsukasa; Suda, Kousuke; Takano, Shigetugu

2009-11-21

194

Esophageal motility disorders after gastric banding.  

PubMed

The long-term effects of gastric banding on esophageal function are not well described. This report describes a 28-year-old woman who developed signs and symptoms of abnormal esophageal motility and lower esophageal sphincter hypotension after gastric banding for morbid obesity. The current literature addressing the effects of gastric banding on esophageal function in light of this case report is discussed. PMID:17509126

O'Rourke, R W; Deveney, C W; McConnell, D B; Wolfe, B M; Jobe, B A

2007-01-01

195

A Comprehensive Review of Esophageal Stents  

PubMed Central

Esophageal stents are important tools for palliative treatment of inoperable esophageal malignancies. With the development of multiple self-expandable stents, there are now several therapeutic options for managing benign and malignant esophageal diseases. This paper discusses the various types of esophageal stents currently available, indications for their placement, challenges and complications that gastroenterologists face when placing these stents, and some of the innovations that will become available in the near future.

Hong, Jinwha; Lam-Tsai, Yvette; Gress, Frank

2012-01-01

196

Long-term efficacy of perioperative chemoradiotherapy on esophageal squamous cell carcinoma  

Microsoft Academic Search

AIM: To investigate the role of perioperative chemora- diotherapy (CRT) in the treatment of locally advanced thoracic esophageal squamous cell carcinoma (ESCC). METHODS: Using preoperative computed tomography (CT)-based staging criteria, 238 patients with ESCC (stage ?-?) were enrolled in this prospective study between January 1997 and June 2004. With informed consent, patients were randomized into 3 groups: preoperative CRT (80

Jin Lv; Xiu-Feng Cao; Lv Ji; Lei Tao; Dong-Dong Wang

2010-01-01

197

Transient Lower Esophageal Sphincter Relaxation in Morbid Obesity  

Microsoft Academic Search

Background  There is strong evidence that morbid obesity is often accompanied by gastroesophageal reflux. Gastroesophageal reflux is caused\\u000a predominantly by transient lower esophageal sphincter relaxations (TLESRs). Only few data are available about TLESRs in patients\\u000a with stage III obesity (body mass index?>?35). The aim of this study was to analyze the frequency and types of TLESRs in patients\\u000a with morbid obesity

J. H. Schneider; M. Küper; A. Königsrainer; B. Brücher

2009-01-01

198

Update: Modern Approaches to the Treatment of Localized Esophageal Cancer  

Microsoft Academic Search

The optimal treatment strategy for esophageal cancer continues to be a topic of debate. Improvements in chemotherapy drugs,\\u000a surgical techniques, and radiotherapy planning and delivery have led to the design of treatment approaches that are specific\\u000a to both the stage of the tumor and the overall performance status of the patient. Surgery continues to be the standard treatment\\u000a option for

James Welsh; Arya Amini; Anna Likhacheva; Daniel Gomez; Marta Davila; Reza J. Mehran; Ritsuko Komaki; Zhongxing Liao; Wayne L. Hofstetter; Manoop S. Bhutani; Jaffer A. Ajani

2011-01-01

199

Gallium-67 imaging in candidal esophagitis  

SciTech Connect

Ga-67 scanning has been used to evaluate esophageal carcinoma. It has demonstrated candidal infection in other body sites and, in one previous case, in the esophagus. The authors present a case of diffuse esophageal uptake of Ga-67 in esophageal candidiasis.

Rundback, J.H.; Goldfarb, C.R.; Ongseng, F. (Beth Israel Medical Center, New York, NY (USA))

1990-01-01

200

Reoperation after esophageal replacement in childhood  

Microsoft Academic Search

Background: Esophageal replacement is associated with significant morbidity that may lead to operative interventions. This study reviews the management and outcome of children who underwent reoperation after esophageal replacement.Methods: Eighteen patients who underwent esophageal replacement from 1985 to 1997 were reviewed retrospectively. Ten patients underwent reoperation. Patient management, perioperative morbidity, and the dietary intake at follow-up were recorded for each

James C. Y Dunn; Eric W Fonkalsrud; Harry Applebaum; William W Shaw; James B Atkinson

1999-01-01

201

The history of esophageal surgery: pediatric aspects  

Microsoft Academic Search

An attempt is made to explore those aspects of the history of esophageal surgery relevant to pediatric practice. In some areas, the history is entirely focused on conditions of particular pediatric significance; esophageal atresia is a classic example of this group. In other areas there is considerable overlap, which varies in extent, with the history of esophageal surgery in adult.

N. A. Myers

1997-01-01

202

Nonmuscle myosin IIA is associated with poor prognosis of esophageal squamous cancer.  

PubMed

Nonmuscle myosin IIA (myosin IIA) is a force-producing protein involved in the process of cell migration. Its expression has been considered as a bad prognostic indicator in stage I lung adenocarcinoma. However, the expression and clinical significance of myosin IIA in esophageal cancer has not been explored. In this study, we investigate the expression level of myosin IIA in 50 esophageal squamous cancer and 30 adjacent normal esophageal tissues by immunohistochemical staining and correlated its expression with clinicopathological features. Myosin IIA was expressed in all esophageal squamous cancer tissues (100%) and 8 of 30 adjacent normal tissues (26.7%, P = 0.000). In cancer tissues, elevated myosin IIA expression level was significantly correlated with increasing metastatic lymph nodes, poorer cancer differentiation, and advanced tumor stage. Further univariate analysis suggested that strong myosin IIA expression was associated with a significantly shorter overall survival (P = 0.021). In addition, MYH9 SiRNA was transfected into esophageal squamous cancer cell line (KYSE-510) to study the role of myosin IIA in cell migration. SiRNA-mediated depletion of myosin IIA in KYSE-510 cells significantly increased cell-matrix adhesion and attenuated cell migration ability (P = 0.000). In conclusion, these findings indicate that overexpression of myosin IIA may contribute to the progression and poor prognosis of esophageal squamous cancer, and this effect may be associated with increased cancer cell migration. PMID:21951916

Xia, Z-K; Yuan, Y-C; Yin, N; Yin, B-L; Tan, Z-P; Hu, Y-R

2011-09-23

203

p53 immunohistochemical expression and patient prognosis in esophageal squamous cell carcinoma.  

PubMed

It is generally accepted that overexpression of p53 protein is associated with poor prognosis in gastric, lung, and other types of cancer. However, the prognostic significance of p53 aberrations in esophageal cancer remains unclear. This is the largest study (n = 266) examining clinical and prognostic features of p53 immunohistochemical expression in esophageal squamous cell carcinoma. In 139 (52 %) esophageal tumors, nuclear immunoreactivity for p53 protein was detected. p53 aberrant expression was not associated with sex, age, preoperative treatment, TNM stage, or histological grade. Furthermore, p53 expression did not correlate with disease-free survival (P = 0.73) or overall survival (P = 0.62). In addition, no significant modification effect by any of the covariates in the survival analysis was observed (all P > 0.15). In conclusion, our large-scale study demonstrates that p53 expression has no impact on the prognosis of esophageal squamous cell carcinoma. PMID:24026664

Murata, Asuka; Baba, Yoshifumi; Watanabe, Masayuki; Shigaki, Hironobu; Miyake, Keisuke; Karashima, Ryuichi; Imamura, Yu; Ida, Satoshi; Ishimoto, Takatsugu; Iwagami, Shiro; Sakamoto, Yasuo; Miyamoto, Yuji; Yoshida, Naoya; Baba, Hideo

2013-09-13

204

Esophageal atresia, duodenal atresia, and unilateral lung agenesis: a case report.  

PubMed

The association of pure esophageal atresia, duodenal atresia, and unilateral lung agenesis has not been reported previously. Here the authors present a case of a newborn with this constellation of anomalies that underwent staged repair. The primary principle guiding treatment was the avoidance of iatrogenic injury to the single lung. Therefore, the order of operations proceeded as follows: (1) placement of a decompressing gastrostomy tube, (2) repair of the duodenal atresia, and (3) repair of the esophageal atresia. The congenital closed loop obstruction caused by the esophageal and duodenal atresias was beneficial in that it resulted in growth by stretching of the distal esophagus, allowing a tension-free primary repair of the esophageal atresia. PMID:15300548

Downard, Cynthia D; Kim, Heung Bae; Laningham, Fred; Fishman, Steven J

2004-08-01

205

Effect of postoperative course on midterm outcome after esophageal resection for cancer.  

PubMed

Esophageal resections are challenging procedures often associated with postoperative complications and a prolonged hospital stay. This study investigated the impact of postoperative course on midterm survival in 35 patients undergoing esophageal resection for malignancy between January 2002 and November 2007. The impact of preoperative and operative variables, pathology, staging, early postoperative complications, and length of hospital stay on midterm survival was determined with Cox regression analysis. During the follow-up period, 17 (48.6%) patients died. Multivariate analysis identified surgical stage and length of stay as independent predictors of midterm survival; in addition, the total number of complications reached statistical significance. In conclusion, in addition to surgical stage, postoperative course has an impact upon midterm survival after esophageal resection. PMID:23814379

Chamogeorgakis, Themistokles; Bhora, Faiz; Toumpoulis, Ioannis; Nabong, Andy; Connery, Cliff

2013-07-01

206

Effect of postoperative course on midterm outcome after esophageal resection for cancer  

PubMed Central

Esophageal resections are challenging procedures often associated with postoperative complications and a prolonged hospital stay. This study investigated the impact of postoperative course on midterm survival in 35 patients undergoing esophageal resection for malignancy between January 2002 and November 2007. The impact of preoperative and operative variables, pathology, staging, early postoperative complications, and length of hospital stay on midterm survival was determined with Cox regression analysis. During the follow-up period, 17 (48.6%) patients died. Multivariate analysis identified surgical stage and length of stay as independent predictors of midterm survival; in addition, the total number of complications reached statistical significance. In conclusion, in addition to surgical stage, postoperative course has an impact upon midterm survival after esophageal resection.

Bhora, Faiz; Toumpoulis, Ioannis; Nabong, Andy; Connery, Cliff

2013-01-01

207

Anion and cation distributions in Fe(II–III) hydroxysalt green rusts from XRD and Mössbauer analysis (carbonate, chloride, sulphate, …); the “fougerite” mineral  

Microsoft Academic Search

Main crystallographic features of Fe(II–III) hydroxysalts usually named green rusts are known from XRD. However, Mössbauer spectroscopy often used to characterise them revealed that several Fe(II) sites exist that have not been elucidated yet. The structure is classified in green rust one, GR1, and green rust two, GR2, according to the sequence of stacking of Fe(OH)2 brucite-like layers that depends

Jean-Marie R. Génin; Christian Ruby

2004-01-01

208

Photovoltage enhancement from cyanobiphenyl liquid crystals and 4-tert-butylpyridine in Co(ii/iii) mediated dye-sensitized solar cells.  

PubMed

Two cyanobiphenyl liquid crystals (LCs), 5CB (4-cyano-4'-pentylbiphenyl) and 8CB (4-cyano-4'-octylbiphenyl), are introduced as additives into Co(ii/iii) electrolytes for dye-sensitized solar cells (DSCs). An electrolyte containing a combination of these LCs and 4-tert-butylpyridine (TBP) exhibits higher photovoltage than one with only TBP, resulting in higher power conversion efficiency. PMID:23985828

Koh, Teck Ming; Li, Hairong; Nonomura, Kazuteru; Mathews, Nripan; Hagfeldt, Anders; Grätzel, Michael; Mhaisalkar, Subodh G; Grimsdale, Andrew C

2013-08-29

209

Synthesis, structural and electrochemical features of alicyclic and aromatic ?, ??- N 2- and- S 2-dioximate macrobicyclic cobalt(II,III) and ruthenium(II) tris-complexes  

Microsoft Academic Search

The triribbed-functionalized cobalt(II,III) and ruthenium(II) clathrochelate derivatives of the vic-dioximes with two nitrogen or sulfur atoms in ?-positions to ?-conjugated diazomethine chelate fragments of a macrobicyclic framework were obtained in moderate yields under mild and high dilution conditions by nucleophilic substitution of six reactive chlorine atoms of the boron-capped macrobicyclic cobalt and ruthenium(II) precursors with N2- and S2-dinucleophiles (ethylenediamine and

Yan Z. Voloshin; Oleg A. Varzatskii; Alexander S. Belov; Zoya A. Starikova; Alexander V. Dolganov; Valentin V. Novikov; Yurii N. Bubnov

2011-01-01

210

Results and insights from the N Reactor Level II\\/III PRA (probabilistic risk assessment) for application to advanced reactor designs  

Microsoft Academic Search

A Level II\\/III probabilistic risk assessment has been performed for N Reactor, a US Department of Energy production reactor. State-of-the-art methodology was employed based on methods developed by Sandia for the US Nuclear Regulatory Commission for the NUREG-1150 study. Latin Hypercube sampling techniques were used to develop uncertainty distributions for the risks associated with postulated core damage events initiated by

G. D. Wyss; D. M. Kunsman; A. L. Camp

1990-01-01

211

Primary esophageal and gastro-esophageal junction cancer xenograft models: clinicopathological features and engraftment.  

PubMed

There are very few xenograft models available for the study of esophageal (E) and gastro-esophageal junction (GEJ) cancer. Using a NOD/SCID model, we implanted 90 primary E and GEJ tumors resected from patients and six endoscopic biopsy specimens. Of 69 resected tumors with histologically confirmed viable adenocarcinoma or squamous cell carcinoma, 22 (32%) was engrafted. One of 11 tumors, considered to have had a complete pathological response to neo-adjuvant chemo-radiation, also engrafted. Of the 23 patients whose tumors were engrafted, 65% were male; 30% were early stage while 70% were late stage; 22% received neo-adjuvant chemo-radiation; 61% were GEJ cancers. Engraftment occurred in 18/54 (33%) adenocarcinomas and 5/16 (31%) squamous cell carcinomas. Small endoscopic biopsy tissue had a 50% (3/6) engraftment rate. Of the factors analyzed, pretreatment with chemo-radiation and well/moderate differentiation showed significantly lower correlation with engraftment (P<0.05). In the subset of patients who did not receive neo-adjuvant chemo-radiation, 18/41 (44%) engrafted compared with those with pretreatment where 5/29 (17%, P=0.02) engrafted. Primary xenograft lines may be continued through 4-12 passages. Xenografts maintained similar histology and morphological characteristics with only minor variations even after multiple passaging in most instances. PMID:23399854

Dodbiba, Lorin; Teichman, Jennifer; Fleet, Andrew; Thai, Henry; Sun, Bin; Panchal, Devang; Patel, Devalben; Tse, Alvina; Chen, Zhuo; Faluyi, Olusola O; Renouf, Daniel J; Girgis, Hala; Bandarchi, Bizhan; Schwock, Joerg; Xu, Wei; Bristow, Robert G; Tsao, Ming-Sound; Darling, Gail E; Ailles, Laurie E; El-Zimaity, Hala; Liu, Geoffrey

2013-02-11

212

Urinary metabolomic signature of esophageal cancer and Barrett's esophagus  

PubMed Central

Background Esophageal adenocarcinoma (EAC) often presents at a late, incurable stage, and mortality has increased substantially, due to an increase in incidence of EAC arising out of Barrett’s esophagus. When diagnosed early, however, the combination of surgery and adjuvant therapies is associated with high cure rates. Metabolomics provides a means for non- invasive screening of early tumor-associated perturbations in cellular metabolism. Methods Urine samples from patients with esophageal carcinoma (n = 44), Barrett’s esophagus (n = 31), and healthy controls (n = 75) were examined using 1H-NMR spectroscopy. Targeted profiling of spectra using Chenomx software permitted quantification of 66 distinct metabolites. Unsupervised (principal component analysis) and supervised (orthogonal partial least-squares discriminant analysis OPLS-DA) multivariate pattern recognition techniques were applied to discriminate between samples using SIMCA-P+ software. Model specificity was also confirmed through comparison with a pancreatic cancer cohort (n = 32). Results Clear distinctions between esophageal cancer, Barrett’s esophagus and healthy controls were noted when OPLS-DA was applied. Model validity was confirmed using two established methods of internal validation, cross-validation and response permutation. Sensitivity and specificity of the multivariate OPLS-DA models were summarized using a receiver operating characteristic curve analysis and revealed excellent predictive power (area under the curve = 0.9810 and 0.9627 for esophageal cancer and Barrett’s esophagus, respectively). The metabolite expression profiles of esophageal cancer and pancreatic cancer were also clearly distinguishable with an area under the receiver operating characteristics curve (AUROC) = 0.8954. Conclusions Urinary metabolomics identified discrete metabolic signatures that clearly distinguished both Barrett’s esophagus and esophageal cancer from controls. The metabolite expression profile of esophageal cancer was also discrete from its precursor lesion, Barrett’s esophagus. The cancer-specific nature of this profile was confirmed through comparison with pancreatic cancer. These preliminary results suggest that urinary metabolomics may have a future potential role in non-invasive screening in these conditions.

2012-01-01

213

Circulating anti-p53 antibodies in esophageal cancer patients.  

PubMed

Circulating anti-p53 protein antibodies (p53-Abs) have been detected in some cancer patients. The aim of the study was to determine the presence of circulating anti-p53 protein antibodies and their clinical significance in patients with esophageal carcinoma. Serum specimens from 75 consecutive patients with squamous cell carcinomas and 10 healthy subjects were studied. Enzyme linked immunosorbent assay (ELISA--Pharma Cell) was used to detect p53-Abs. At the time of diagnosis 20 (26.6%) of 75 analyzed patients had positive result in the p53-Abs test, but not any of the healthy subjects. The positive rate was 25% (1/4) cases in stage I, 41% (10/24) cases in stage IIA, 0% (0/8) cases in stage IIB, 28% (8/28) cases in stage III and 9% (1/11) cases in stage IV. In respect of tumour differentiation, cases graded as G1, G2 and G3 were positive in 28.5% (4/14), 25.9% (7/27) and 26.4% (9/34), respectively. There was no correlation between presence of p53-Abs and stage, rumour differentiation, lymph nodes metastases, tumour size, patient age and sex. In conclusion, the results of the present study indicate that serum p53-Abs did not correlate with cliniocopathologic feature of esophageal carcinoma. PMID:11820593

Koz?owski, M; Kovalchuk, O; Nikli?ski, J; Chyczewski, L; Staros?awska, E; Ciecha?ski, A; Dabrowski, A; Nikli?ska, W; Dziegielewski, P; Lapu?, G; Wallner, G; Lauda?ski, J

2001-01-01

214

Photodynamic therapy in early esophageal squamous cell carcinoma  

NASA Astrophysics Data System (ADS)

From 1/1985 to 7/1993, 18 patients underwent endoscopic photodynamic therapy (PDT) for early stage esophageal squamous cell carcinoma -- as two patients had two synchronous esophageal cancers, 20 lesions were treated. Tumors were staged as Tis in 7 cases and T1 in 13. The average light energy delivered was 50 J/cm2 and 70 J/cm2 for the treatment of Tis and T1, respectively. To obtain a more uniform distribution of laser light in 12 cases the irradiation was performed through the wall of a transparent tube previously placed over the endoscope and advanced into the stomach. The overall results show a complete response in 14/20 (70%) tumors. Three patients developed a local recurrence, 6, 12, and 14 months after therapy. After a follow-up of 5 to 75 months, there was no evidence of disease in 10/18 patients (56%). The actuarial survival rate was 95%, 79%, and 26% at 1, 3, and 5 years, respectively. Complications were skin reaction in one patient and esophageal stenosis at the treatment site, that gradually responded to endoscopic bougienage, in 2 patients. Endoscopic PDT proved to be safe and effective in the treatment of superficial carcinoma of the esophagus.

Spinelli, Pasquale; Dal Fante, Marco; Mancini, Andrea; Massetti, Renato; Meroni, Emmanuele

1994-10-01

215

Photodynamic therapy in early esophageal squamous cell carcinoma  

NASA Astrophysics Data System (ADS)

From 1/1985 to 7/1993, 18 patients underwent endoscopic photodynamic therapy (PDT) for early stage esophageal squamous cell carcinoma -- as two patients had two synchronous esophageal cancers, 20 lesions were treated. Tumors were staged as Tis in 7 cases and T1 in 13. The average light energy delivered was 50 J/cm2 and 70 J/cm2 for the treatment of Tis and T1, respectively. To obtain a more uniform distribution of laser light in 12 cases the irradiation was performed through the wall of a transparent tube previously placed over the endoscope and advanced into the stomach. The overall results show a complete response in 14/20 (70%) tumors. Three patients developed a local recurrence, 6, 12, and 14 months after therapy. After a follow-up of 5 to 75 months, there was no evidence of disease in 10/18 patients (56%). The actuarial survival rate was 95%, 79%, and 26% at 1, 3, and 5 years, respectively. Complications were skin reaction in one patient and esophageal stenosis at the treatment site, that gradually responded to endoscopic bougienage, in 2 patients. Endoscopic PDT proved to be safe and effective in the treatment of superficial carcinoma of the esophagus.

Spinelli, Pasquale; dal Fante, Marco; Mancini, Andrea; Massetti, Renato; Meroni, Emmanuele

1995-03-01

216

Thoracic complications of esophageal disorders.  

PubMed

Abnormalities of the esophagus are common, and complications associated with these disorders and diseases can involve the mediastinum, tracheobronchial tree, and lungs. The most common complications include mediastinitis secondary to esophageal perforation or postoperative anastomotic leak, or both; empyema due to fistula formation; and aspiration pneumonia. The authors reviewed the radiologic appearances of those and other common thoracic complications associated with esophageal disorders to facilitate early detection, diagnosis, and management. Computed tomographic (CT) findings of acute mediastinitis secondary to esophageal perforation may include esophageal thickening, extraluminal gas, pleural effusion, single or multiple abscesses, and extraluminal contrast medium. The radiologic manifestations of pneumonia secondary to tracheoesophageal fistula are variable, depending on the spread and severity of the aspiration. The most common radiographic pattern is that of bronchopneumonia with scattered air-space opacities. CT has been regarded as the imaging modality of choice for the evaluation of suspected esophagopleural fistula, because the site of communication between the pleural space and the esophagus can often be seen. An awareness of the radiologic manifestations of these complications is thus required to facilitate early diagnosis. PMID:12376614

Giménez, Ana; Franquet, Tomás; Erasmus, Jeremy J; Martínez, Santiago; Estrada, Pilar

2002-10-01

217

Esophageal manifestations of celiac disease.  

PubMed

Celiac disease (CD) may often be associated with various motor disorders affecting the different segments of the digestive tract, including the esophagus. Although it has not been universally reported, some available evidences indicate that pediatric and adult celiac patients could manifest a higher frequency of esophagitis and gastroesophageal reflux disease-related symptoms compared to nonceliac patients. In addition, several published studies have consistently shown the efficacy of a gluten-free diet in rapidly controlling esophageal symptoms and in preventing their recurrence. Since the participation of gluten in the esophageal symptoms of CD seems clear, its intimate mechanisms have yet to be elucidated, and several hypothesis have been proposed, including the specific immune alterations characterizing CD, the reduction in nutrient absorption determining the arrival of intact gluten to distal gastrointestinal segments, and various dysregulations in the function of gastrointestinal hormones and peptides. Recent studies have suggested the existence of a possible relationship between CD and eosinophilic esophagitis, which should be more deeply investigated. PMID:21438963

Lucendo, A J

2011-03-25

218

Survival Trends in Patients With Gastric and Esophageal Adenocarcinomas: A Population-Based Study  

PubMed Central

OBJECTIVE To use a population-based approach to describe survival trends in patients diagnosed as having gastric or esophageal adenocarcinoma. PATIENTS AND METHODS A population-based complete chart review of all inpatient and outpatient records, using the resources of the Rochester Epidemiology Project, was conducted in Olmsted County, Minnesota (population 124,277), a primarily rural county with one large urban area. All residents of Olmsted County who were diagnosed as having gastric or esophageal adenocarcinoma from January 1, 1971, through December 31, 2000, were included in the study. The main outcomes were median survival and 2-year and 5-year survival rates, by decade of diagnosis. RESULTS From 1971 through 2000, median survival for patients with gastric adenocarcinoma (n=121) decreased from 5.5 months to 3.2 months, whereas median survival for patients with esophageal adenocarcinoma (n=65) increased from 8.5 months to 11.7 months. Decade of diagnosis was not significantly associated with patient survival for either gastric or esophageal adenocarcinoma (P>.05). There was no significant shift in stage of disease at diagnosis during the 30-year period for either gastric or esophageal adenocarcinoma (P>.05). CONCLUSION No significant change has occurred in the survival rates of this patient population with gastric or esophageal adenocarcinoma, which is representative of the US white population.

Crane, Sarah J.; Locke, G. Richard; Harmsen, William S.; Zinsmeister, Alan R.; Romero, Yvonne; Talley, Nicholas J.

2008-01-01

219

Expression and clinical significance of the DNA repair enzyme MYH in esophageal squamous cell carcinoma.  

PubMed

MYH is an important enzyme in combating DNA oxidative stress in the occurrence and development of various types of tumors. To investigate the correlation between expression of the DNA repair enzyme MYH in esophageal squamous cell carcinoma and 8-oxoguanine (8-oxoG) oxidative damage, as well as the clinical significance of altered MYH expression, tissues from 175 esophageal carcinoma cases were investigated in the present study. MYH expression and 8-oxoG oxidative damage in squamous cell carcinoma and adjacent normal tissue were assessed by immunohistochemistry and Western blotting. In 82.9% (145/175) of the cases, MYH protein expression in esophageal squamous cell carcinoma was lower than that of adjacent normal tissue (t=4.24, P<0.001). Additionally, 8-oxoG staining was higher in the tumors than in the normal tissue. Lower expression of MYH in esophageal squamous cell carcinoma was associated with depth of invasion, venous invasion, TNM stage and lymph node metastasis (P<0.05). In conclusion, a lower MYH expression level in esophageal cell carcinoma tissue was inversely associated with more severe 8-oxoG oxidative damage, suggesting that changes in MYH activity correspond to increased DNA damage in tumor cells. The use of MYH expression as a postoperative index for esophageal squamous cell carcinoma may guide the formulation of individualized chemotherapy for patients after surgery. PMID:22977630

Shen, Kai; Ji, Yong; Chen, Guo-Qiang; Huang, Bin; Zhang, Xian; Wu, Song; Yu, Gui-Ping; Wang, Xiao-Chen

2011-07-20

220

Esophageal cancer proliferation is mediated by cytochrome P450 2C9 (CYP2C9).  

PubMed

Cytochrome P450 epoxygenases (CYP450) have been recently shown to promote malignant progression. Here we investigated the mRNA and protein expression and potential clinical relevance of CYP2C9 in esophageal cancer. Highest expression was detected in esophageal adenocarcinoma (EAC; n=78) and adjacent esophageal mucosa (NEM; n=79). Levels of CYP2C9 in EAC and NEM were significantly higher compared to esophageal squamous cell carcinoma (ESCC; n=105). Early tumor stages and well-differentiated tumors showed a significantly higher CYP2C9 expression compared to progressed tumors. Moreover, CYP2C9 expression was correlated to high Ki-67 labeling indices in EAC and Ki-67 positive tumor cells in EAC and ESCC. Selective inhibition of CYP2C9 decreased tumor cell proliferation (KYSE30, PT1590 and OE19) in vitro, which was abolished by 11,12-epoxyeicosatrienoic acid (11,12-EET). Cell-cycle analysis using FACS revealed that inhibition of CYP2C9 leads to a G0/G1 phase cell-cycle arrest. CYP2C9 seems to be relevant for early esophageal cancer development by promoting tumor cell proliferation. Pharmacological inhibition of CYP2C9 might contribute to a more efficient therapy in CYP2C9 highly expressing esophageal cancers. PMID:21167292

Schmelzle, Moritz; Dizdar, Levent; Matthaei, Hanno; Baldus, Stephan E; Wolters, Judith; Lindenlauf, Nina; Bruns, Ingmar; Cadeddu, Ron-Patrick; Kröpil, Feride; Topp, Stefan A; Schulte am Esch, Jan; Eisenberger, Claus F; Knoefel, Wolfram T; Stoecklein, Nikolas H

2010-12-15

221

From the radiologic pathology archives: esophageal neoplasms: radiologic-pathologic correlation.  

PubMed

Esophageal neoplasms have a wide spectrum of clinical features, pathologic findings, and imaging manifestations. Leiomyomas are the most common benign esophageal neoplasm, typically appearing as smoothly marginated intramural masses. Fibrovascular polyps arise in the cervical esophagus, gradually elongating as they are pulled inferiorly by esophageal peristalsis. Granular cell tumors are generally incidental small intramural masses with an appearance similar to that of leiomyomas. Malignant esophageal neoplasms are a common cause of cancer mortality, particularly squamous cell carcinoma (SCC) and adenocarcinoma. Both of these tumors occur in older men, most often appearing as irregular infiltrative lesions at barium examination, with evidence of tumor spread beyond the esophagus at cross-sectional imaging. Adenocarcinoma arises from Barrett esophagus and is much more likely than SCC to involve the gastroesophageal junction. Esophageal involvement by lymphoma is usually secondary to tumor spread from the stomach or mediastinum. Spindle cell carcinoma is a biphasic malignancy with carcinomatous and sarcomatous elements that forms a bulky polypoid intraluminal mass. Neuroendocrine carcinoma is an aggressive neoplasm that may be hypervascular and is usually associated with metastatic disease at presentation. Understanding the imaging appearances and pathologic bases of esophageal neoplasms is essential for their detection, differential diagnosis, staging, and treatment planning. PMID:23842973

Lewis, Rachel B; Mehrotra, Anupamjit K; Rodriguez, Pablo; Levine, Marc S

222

Clinical characteristics and treatment of esophageal atresia: a single institutional experience  

PubMed Central

Purpose Treatment for esophageal atresia has advanced over several decades due to improvements in surgical techniques and neonatal intensive care. Subsequent to increased survival, postoperative morbidity has become an important issue in this disease. The aim of our study was to analyze our experience regarding the treatment of esophageal atresia. Methods We reviewed and analyzed the clinical data of patients who underwent surgery for esophageal atresia at Severance Children's Hospital from 1995 to 2010 regarding demographics, surgical procedures, and postoperative outcomes. Results Seventy-two patients had surgery for esophageal atresia. The most common gross type was C (81.9%), followed by type A (15.3%). Primary repair was performed in 52 patients. Staged operation was performed in 17 patients. Postoperative esophageal strictures developed in 43.1% of patients. Anastomotic leakages occurred in 23.6% of patients, and recurrence of tracheoesophageal fistula was reported in 8.3% of patients. Esophageal stricture was significantly associated with long-gap (?3 cm or three vertebral bodies) atresia (P = 0.042). The overall mortality rate was 15.3%. The mortality in patients weighing less than 2.5 kg was higher than in patients weighing at least 2.5 kg (P = 0.001). During the later period of this study, anastomotic leakage and mortality both significantly decreased compared to the earlier study period (P = 0.009 and 0.023, respectively). Conclusion The survival of patients with esophageal atresia has improved over the years and the rate of anastomotic leakage has been significantly reduced. However, overall morbidities related to surgical treatment of esophageal atresia still exists with high incidence.

Chang, Eun Young; Chang, Hye Kyung; Han, Seok Joo; Choi, Seung Hoon; Hwang, Eui Ho

2012-01-01

223

Identification of a novel SEREX antigen family, ECSA, in esophageal squamous cell carcinoma  

PubMed Central

Background Diagnosis of esophageal squamous cell carcinoma (SCC) may improve with early diagnosis. Currently it is difficult to diagnose SCC in the early stage because there is a limited number of tumor markers available. Results Fifty-two esophageal SCC SEREX antigens were identified by SEREX (serological identification of antigens by recombinant cDNA expression cloning) using a cDNA phage library and sera of patients with esophageal SCC. Sequence analysis revealed that three of these antigens were similar in amino acid sequences, and they were designated as ECSA (esophageal carcinoma SEREX antigen)-1, -2 and -3. The ECSA family was also similar to an EST clone, hepatocellular carcinoma-associated antigen 25a (HCA25a). Serum antibody levels to ECSA-1, -2 and -3 were significantly higher in patients with esophageal SCC than in healthy donors. Based on the conserved amino acid sequences, three peptides were synthesized and used for enzyme-linked immunosorbent assays (ELISA). The serum antibody levels against one of these peptides were significantly higher in patients with esophageal SCC. This peptide sequence was also conserved in FAM119A, GOSR1 and BBS5, suggesting that these are also ECSA family members. Reverse transcription followed by quantitative PCR analysis showed that the mRNA expression levels of ECSA-1, -2 and -3 and FAM119A but not of HCA25a, GOSR1 and BBS5 were frequently elevated in esophageal SCC tissues. Conclusions We have identified a new gene family designated ECSA. Serum antibodies against the conserved domain of the ECSA family may be a promising tumor marker for esophageal SCC.

2011-01-01

224

Esophageal wall blood perfusion during contraction and transient lower esophageal sphincter relaxation in humans  

PubMed Central

We recently reported that esophageal contraction reduces esophageal wall perfusion in an animal study. Our aim was to determine esophageal wall blood perfusion (EWBP) during esophageal contraction and transient lower esophageal sphincter relaxations (TLESRs) in humans. We studied 12 healthy volunteers. A custom-designed laser Doppler probe was anchored to the esophageal wall, 4–6 cm above the LES, by use of the Bravo pH system so that the laser light beam stay directed toward the esophageal mucosa. A high-resolution manometry equipped with impedance electrodes recorded esophageal pressures and reflux events. Synchronized pressure, impedance, pH, and EWBP recordings were obtained during dry and wet swallows and following a meal. Stable recordings of laser Doppler EWBP were only recorded when the laser Doppler probe was firmly anchored to the esophageal wall. Esophageal contractions induced by dry and wet swallows resulted in 46 ± 9% and 60 ± 10% reduction in the EWBP, respectively (compared to baseline). Reduction in EWBP was directly related to the amplitude (curvilinear fit) and duration of esophageal contraction. Atropine reduced the esophageal contraction amplitude and decreased the EWBP reduction associated with esophageal contraction. TLESRs were also associated with reduction in the EWBP, albeit of smaller amplitude (29 ± 3%) but longer duration (19 ± 2 s) compared with swallow-induced esophageal contractions. We report 1) an innovative technique to record EWBP for extended time periods in humans and 2) contraction of circular and longitudinal muscle during peristalsis and selective longitudinal muscle contraction during TLESR causes reduction in the EWBP; 3) using our innovative technique, future studies may determine whether esophageal wall ischemia is the cause of esophageal pain/heartburn.

Jiang, Yanfen; Bhargava, Valmik; Kim, Young Sun

2012-01-01

225

Long-term outcome of esophageal anastomosis.  

PubMed

After repair of esophageal atresia (EA) in a newborn, esophageal dysmotility presenting as dysphagia and symptomatic gastroesophageal reflux are common. Significant esophageal morbidity associated with EA extends into adulthood. In adulthood approximately one-fifth of the patients have developed epithelial metaplastic changes, one-third of these have intestinal metaplasia (Barrett esophagus). Surgical complications, increasing age, and impaired esophageal motility predict the development of epithelial metaplasia after repair of EA. To date, worldwide, eight cases of esophageal cancer have been reported in young adults treated for EA. Incidence of esophageal cancer after EA repair is very much likely to increase in the future. Life-long endoscopic follow-up is warranted in patients with EA. PMID:23737132

Rintala, R J; Pakarinen, M P

2013-06-04

226

Fragility of the esophageal mucosa: A pathognomonic endoscopic sign of primary eosinophilic esophagitis?  

Microsoft Academic Search

Background: Primary eosinophilic esophagitis, a chronic inflammatory disorder of the esophagus, evokes recurrent dysphagia. Endoscopy is often unremarkable, and no consensus exists regarding management of resultant dysphagia. The response of a series of patients with primary eosinophilic esophagitis to dilation is reported together with a description of a possibly pathognomonic sign: fragile esophageal mucosa, for which the term “crêpe-paper” mucosa

Alex Straumann; Livio Rossi; Hans-Uwe Simon; Pius Heer; Hans-Peter Spichtin; Christoph Beglinger

2003-01-01

227

Transtracheal Esophageal Stent Removal: A Case-Series  

PubMed Central

Benign esophagorespiratory fistula is a rare but often lethal affection and difficult to cure. Possible treatments are surgery or esophageal stenting but may fail and cause respiratory failure. Two patients with spontaneous esophagorespiratory fistula after chemoradiotherapy for an esophageal malignancy were both treated by esophageal exclusion but esophageal stent were left in place. The esophageal stents were transtracheally removed through the fistula. The removals were successful, patients could leave Intensive Care Unit and returned home. Transtracheal esophageal stent removal is technically possible but very risky. Such situations must be avoided: esophageal stents must absolutely be removed before esophageal exclusion.

Buiret, Guillaume; Guiraud, Michel; Pierron, Jerome; Schoeffler, Mathieu; Duperret, Serge; Baulieux, Jacques; Wander, Lionel; Poupart, Marc; Pignat, Jean-Christian

2013-01-01

228

Extended lymphadenectomy in esophageal cancer is debatable.  

PubMed

Surgery is an essential part of the treatment of patients with esophageal carcinoma. However, there is no consensus on whether the surgical technique can be improved to promote better survival outcome. Specifically, the real value of the addition of a radical lymphadenectomy to the esophageal resection is still elusive and controversial. This paper focuses on the debate of esophagectomy and lymphadenectomy for the treatment of esophageal cancer. PMID:23553174

Herbella, Fernando A M; Laurino Neto, Rafael M; Allaix, Marco E; Patti, Marco G

2013-08-01

229

Adenosine-induced activation of esophageal nociceptors  

PubMed Central

Clinical studies implicate adenosine acting on esophageal nociceptive pathways in the pathogenesis of noncardiac chest pain originating from the esophagus. However, the effect of adenosine on esophageal afferent nerve subtypes is incompletely understood. We addressed the hypothesis that adenosine selectively activates esophageal nociceptors. Whole cell perforated patch-clamp recordings and single-cell RT-PCR analysis were performed on the primary afferent neurons retrogradely labeled from the esophagus in the guinea pig. Extracellular recordings were made from the isolated innervated esophagus. In patch-clamp studies, adenosine evoked activation (inward current) in a majority of putative nociceptive (capsaicin-sensitive) vagal nodose, vagal jugular, and spinal dorsal root ganglia (DRG) neurons innervating the esophagus. Single-cell RT-PCR analysis indicated that the majority of the putative nociceptive (transient receptor potential V1-positive) neurons innervating the esophagus express the adenosine receptors. The neural crest-derived (spinal DRG and vagal jugular) esophageal nociceptors expressed predominantly the adenosine A1 receptor while the placodes-derived vagal nodose nociceptors expressed the adenosine A1 and/or A2A receptors. Consistent with the studies in the cell bodies, adenosine evoked activation (overt action potential discharge) in esophageal nociceptive nerve terminals. Furthermore, the neural crest-derived jugular nociceptors were activated by the selective A1 receptor agonist CCPA, and the placodes-derived nodose nociceptors were activated by CCPA and/or the selective adenosine A2A receptor CGS-21680. In contrast to esophageal nociceptors, adenosine failed to stimulate the vagal esophageal low-threshold (tension) mechanosensors. We conclude that adenosine selectively activates esophageal nociceptors. Our data indicate that the esophageal neural crest-derived nociceptors can be activated via the adenosine A1 receptor while the placodes-derived esophageal nociceptors can be activated via A1 and/or A2A receptors. Direct activation of esophageal nociceptors via adenosine receptors may contribute to the symptoms in esophageal diseases.

Ru, F.; Surdenikova, L.; Brozmanova, M.

2011-01-01

230

Esophageal atresia\\/tracheoesophageal fistula and associated congenital esophageal stenosis  

Microsoft Academic Search

Background. The association of congenital stenosis of the distal esophagus (CES) in children with esophageal atresia\\/tracheoesophageal\\u000a fistula complex (TEF) has been described but is thought to be rare. Most reports have been of individual or small numbers\\u000a of cases. Objective. The objective of the study was to evaluate the incidence, clinical and radiographic features of CES associated with TEF,\\u000a and

Beverley Newman; Thomas M. Bender

1997-01-01

231

A Japanese case of eosinophilic esophagitis.  

PubMed

Eosinophilic esophagitis (EE) is a rarely diagnosed condition involving eosinophilic infiltration of the esophageal mucosa. Here we present a case of EE in a 69-year-old Japanese man, who presented with abdominal pain, appetite loss, and a history of bronchial asthma. Laboratory findings included peripheral eosinophilia and an increased serum immunoglobulin E level. Computed tomography showed diffuse severe thickening of the esophageal wall, and a barium esophagogram revealed a small caliber of the middle and lower portion of the esophagus, without normal peristaltic contractions. Endoscopy of the esophagus showed a pale mucosa, with adherent whitish exudates resembling fungal infection, and prominent ring-like contractions. Histologic examination of a biopsy specimen revealed marked eosinophil infiltration into the esophageal mucosa. Endoscopic ultrasonography (EUS) demonstrated marked circumferential thickening of the esophageal submucosal layer, and an esophageal manometry study showed a high percentage of ineffective esophageal peristalsis and high-amplitude esophageal body contractions. EUS findings showed no change even after oral corticosteroid therapy, although the histological findings were improved. This is thought to be the first documented Japanese case of EE. EE should be considered in the differential diagnosis in cases of esophageal motility disturbance, even if the patients do not complain of dysphagia. PMID:16933010

Furuta, Koichiro; Adachi, Kyoichi; Kowari, Kentaro; Mishima, Yuko; Imaoka, Hiroshi; Kadota, Chikara; Koshino, Kenji; Miyake, Tatsuya; Kadowaki, Yasunori; Furuta, Kenji; Kazumori, Hideaki; Sato, Shuichi; Ishihara, Shunji; Amano, Yuji; Honda, Masaaki; Kinoshita, Yoshikazu

2006-07-01

232

Pathophysiology of Portal Hypertension and Esophageal Varices  

PubMed Central

Esophageal varices are the major complication of portal hypertension. It is detected in about 50% of cirrhosis patients, and approximately 5–15% of cirrhosis patients show newly formed varices or worsening of varices each year. The major therapeutic strategy of esophageal varices consists of primary prevention, treatment for bleeding varices, and secondary prevention, which are provided by pharmacological, endoscopic, interventional and surgical treatments. Optimal management of esophageal varices requires a clear understanding of the pathophysiology and natural history. In this paper, we outline the current knowledge and future prospect in the pathophysiology of esophageal varices and portal hypertension.

Maruyama, Hitoshi; Yokosuka, Osamu

2012-01-01

233

Incidence and specificity of antibodies to types I, II, III, IV, and V collagen in rheumatoid arthritis and other rheumatic diseases as measured by 125I-radioimmunoassay  

SciTech Connect

Antibodies to human native and denatured types I, II, III, IV, and V collagens were measured using 125I-radioimmunoassay. Mean levels of binding by sera from 30 rheumatoid arthritis patients were significantly higher than those from 20 normal subjects against all of the collagens tested. The relative antibody concentration was higher in synovial fluid than in simultaneously obtained serum. Many patients with gout or various other rheumatic diseases also had detectable anticollagen antibodies. With a few notable exceptions, the majority of the reactivity detected in all patient groups was directed against covalent structural determinants present on all of the denatured collagens, suggesting a secondary reaction to tissue injury.

Stuart, J.M.; Huffstutter, E.H.; Townes, A.S.; Kang, A.H.

1983-07-01

234

[Surgical treatment of esophageal diverticula].  

PubMed

The aim of this paper is to evaluate the methods and therapeutic principles of esophageal diverticula pathology. We analyze the main pathological mechanisms which establish the therapeutic attitude linked with a complex pretherapeutic evaluation. In our study we enrolled 12 patients operated between 2001-2009 for esophageal diverticula with different topography. In this period of time there were much more patients diagnosed with this pathology, but the need for surgery was establish very tight regarding the actual practical guide which impose the identification and interception of physiological mechanisms by the surgical procedure. We highlight the particular technical details, as well as the important differences of postoperatory complications according to the topography of the diverticula pouch. PMID:21523958

Constantinoiu, S; Constantin, A; Predescu, D; Mates, I N; Mocanu, A; Gheorghe, M; Hoar?, P; Achim, F; Cociu, L

235

Management of Barrett's esophageal carcinoma.  

PubMed

Barrett's esophagus (BE) is the premalignant lesion from which esophageal adenocarcinoma near the esophagogastric junction arises. The management of BE and the treatment of Barrett's esophageal adenocarcinoma (BEA) are important clinical issues in Europe and the United States. As the Helicobacter pylori infection rate in Japan is decreasing in the younger population, the incidence of BE and adenocarcinoma arising from BE may start increasing. Thus, we review the current status of BEA and its management. Magnifying endoscopy with narrow-band imaging is important for diagnosing dysplasia arising from BE. In Japan, adenocarcinoma arising from BE is managed the same way as squamous cell carcinoma in the same location. Strategies to prevent BEA may include medication such as non-steroidal anti-inflammatory drugs and proton pump inhibitors, and anti-reflux surgery. Understanding the pathophysiology of BE will help to reduce the incidence of BEA. PMID:23283352

Miyazaki, Tatsuya; Inose, Takanori; Tanaka, Naritaka; Yokobori, Takehiko; Suzuki, Shigemasa; Ozawa, Daigo; Sohda, Makoto; Nakajima, Masanobu; Fukuchi, Minoru; Kato, Hiroyuki; Kuwano, Hiroyuki

2013-01-03

236

Vitiligo Associated with Esophageal Adenocarcinoma  

PubMed Central

Vitiligo is a disease that results in depigmented areas in the skin. It may develop at any age but the average age at onset is 20 years. Association of vitiligo and melanoma has been commonly reported, but malignancies other than melanoma have been rarely associated with vitiligo. We report a 73-year-old patient with new onset vitiligo who developed esophageal adenocarcinoma in the following years.

Asilian, Ali; Momeni, Iman; Khosravani, Parastou

2013-01-01

237

Nonsurgical approaches to esophageal malignancy  

Microsoft Academic Search

Esophageal cancer remains one of the leading causes of cancer death worldwide. Patients generally present with progressive\\u000a dysphagia, malnutrition, and weight loss. The diagnosis commonly involves radiologic studies and conventional esophagogastroduodenoscopy.\\u000a Advances in endoscopic evaluation have allowed early detection of premalignant and malignant lesions. These techniques include\\u000a chromoscopy, which can be performed in conjunction with high-resolution\\/magnification endoscopy, and fluorescent endoscopy.

Darius Sorbi; David E. Fleischer

2003-01-01

238

Laryngospasm and pediatric eosinophilic esophagitis  

Microsoft Academic Search

Objective: Symptoms of pediatric eosinophilic esophagitis (EoE) include dysphagia, emesis, regurgitation and feeding difficulties. This symptom complex has been mistaken for refractory gastroesophageal reflux disease (GERD). Whether EoE and GERD are related is controversial. Recently, EoE has been associated with upper airway manifestations including recurrent sinusitis, cough, wheezing, pneumonia, laryngeal edema, and subglottic stenosis. Laryngospasm secondary to EoE has not

Carrie L. Francis; Troy Gibbons; Gresham T. Richter

2010-01-01

239

Esophageal atresia, duodenal atresia, and unilateral lung agenesis: A case report  

Microsoft Academic Search

The association of pure esophageal atresia, duodenal atresia, and unilateral lung agenesis has not been reported previously. Here the authors present a case of a newborn with this constellation of anomalies that underwent staged repair. The primary principle guiding treatment was the avoidance of iatrogenic injury to the single lung. Therefore, the order of operations proceeded as follows: (1) placement

Cynthia D. Downard; Heung Bae Kim; Fred Laningham; Steven J. Fishman

2004-01-01

240

Neurofilament Heavy Polypeptide Regulates the Akt-beta-Catenin Pathway in Human Esophageal Squamous Cell Carcinoma  

Microsoft Academic Search

Aerobic glycolysis and mitochondrial dysfunction are common features of aggressive cancer growth. We observed promoter methylation and loss of expression in neurofilament heavy polypeptide (NEFH) in a significant proportion of primary esophageal squamous cell carcinoma (ESCC) samples that were of a high tumor grade and advanced stage. RNA interference-mediated knockdown of NEFH accelerated ESCC cell growth in culture and increased

Myoung Sook Kim; Xiaofei Chang; Cynthia Lebron; Jatin K. Nagpal; Juna Lee; Yiping Huang; Keishi Yamashita; Barry Trink; Edward A. Ratovitski; David Sidransky; Michael Polymenis

2010-01-01

241

Development of a Multicomponent Prediction Model for Acute Esophagitis in Lung Cancer Patients Receiving Chemoradiotherapy  

Microsoft Academic Search

Purpose: To construct a model for the prediction of acute esophagitis in lung cancer patients receiving chemoradiotherapy by combining clinical data, treatment parameters, and genotyping profile. Patients and Methods: Data were available for 273 lung cancer patients treated with curative chemoradiotherapy. Clinical data included gender, age, World Health Organization performance score, nicotine use, diabetes, chronic disease, tumor type, tumor stage,

Kim De Ruyck; Nick Sabbe; Cary Oberije; Katrien Vandecasteele; Olivier Thas; Dirk De Ruysscher; Phillipe Lambin; Jan Van Meerbeeck; Wilfried De Neve; Hubert Thierens

2011-01-01

242

Delayed metastasis to the mandible of esophageal adenocarcinoma.  

PubMed

Around 1 % of oral cancers are metastases from distant sites. Tumor metastases to the jaw bones are uncommon and are most likely to arise from primary lung, breast, prostate or kidney tumors. Jaw bone metastases from a primary esophageal adenocarcinoma are especially rare, with only 7 reports published in the literature. Here, we describe a case of a 69 year-old male patient where 7 years elapsed between the diagnosis and successful treatment of a poorly differentiated, stage pT2N0 primary esophageal adenocarcinoma and re-presentation with jaw pain due to a metastatic mandibular deposit. The morphological appearance of the metastasis and immunohistochemical positivity with CK20, CK7 and CDX2 strongly supported an adenocarcinoma of upper gastrointestinal tract origin. This case is of particular interest as there is an unusually long time between the detection of the primary esophageal adenocarcinoma and diagnosis of metastatic disease. The longest period of time we have found for this in the literature is 9 months, although it is also reported that some oral metastases may appear more than 10 years following the primary tumor diagnosis. PMID:23740162

Lawes, Kathryn P; Danford, Martin; Di Palma, Silvana

2013-06-06

243

Basics Pathogenesis of Eosinophilic Esophagitis  

PubMed Central

Eosinophilic esophagitis (EE) is a newly recognized disease, which has largely been called idiopathic EE, emphasizing the poor understanding of its pathogenesis. EE is a severe disease of the esophagus characterized by an accumulation of eosinophils in the esophageal mucosa. EE is highly associated with atopic disease and emerging evidence suggests a primary role for food antigen sensitization in disease etiology. Nevertheless, the nomenclature “Eosinophilic esophagitis” describes only the surface of the iceberg of a complex disorder. Epithelial cells, fibroblasts, endothelial cells and smooth muscles cells are involved in pathologic features of the disease and numerous leukocyte subtypes are recruited (eosinophils, mast cells, lymphocytes). As such, the pathogenesis of EE involves multiple tissues, cell types, genes and derives from complex genetic and environmental factors. “Pathogenesis” is a fusion of two Greek words pathos (disease) and genesis (development). In this review, we aim to define the fundamental piece of knowledge available today that characterizes the mechanisms by which certain etiological factors cause EE, reviewing human studies, murine models and recent knowledge regarding the involvement of environmental, cellular, molecular and genetic factors in the development of EE.

Blanchard, Carine; Rothenberg, Marc E.

2008-01-01

244

Pharmacologic influence on esophageal varices  

SciTech Connect

Selective catherization of the left gastric vein was performed after percutaneous transhepatic portography (PTP) in patients with portal hypertension and esophageal varices. Following the hypothesis that drugs increasing the lower esophageal sphincter (LES) pressure may obstruct the variceal blood flow throught the lower esophagus, the effect of different drugs (i.e., intravenous injection of vasopressin, pentagastrin, domperidone and somatostatin and subcutaneous injection of metacholine) on the variceal blood flow was examined. Vasopressin did not change the variceal blood flow; pentagastrine, with its known effect of increasing the LES pressure produced a total interruption of the flow in four of eight patients; domperiodone, also known to increase the LES pressure obstructed the variceal blood flow in the only patient examined with this drug; somatostatin has no reported action on the LES but blocked the flow in one of two patients; and metacholine, reported to increase the LES pressure did not produce any change in the flow in the three patients examined. LES pressure was recorded before and during vasopressin infusion in seven patients with portal hypertension and esophageal varices. No reaction on the pressure was found. The patient number in the study is small and the results are nonuniform but still they suggest that drugs increasing the LES tonus might be useful to control variceal blood flow.

Lunderquist, A.; Owman, T.; Alwmark, A.; Gullstrand, P.; Hall-Angeras, M.; Joelsson, B.; Tranberg, K.G.; Pettersson, K.I.

1983-06-01

245

Current knowledge on esophageal atresia  

PubMed Central

Esophageal atresia (EA) with or without tracheoesophageal fistula (TEF) is the most common congenital anomaly of the esophagus. The improvement of survival observed over the previous two decades is multifactorial and largely attributable to advances in neonatal intensive care, neonatal anesthesia, ventilatory and nutritional support, antibiotics, early surgical intervention, surgical materials and techniques. Indeed, mortality is currently limited to those cases with coexisting severe life-threatening anomalies. The diagnosis of EA is most commonly made during the first 24 h of life but may occur either antenatally or may be delayed. The primary surgical correction for EA and TEF is the best option in the absence of severe malformations. There is no ideal replacement for the esophagus and the optimal surgical treatment for patients with long-gap EA is still controversial. The primary complications during the postoperative period are leak and stenosis of the anastomosis, gastro-esophageal reflux, esophageal dysmotility, fistula recurrence, respiratory disorders and deformities of the thoracic wall. Data regarding long-term outcomes and follow-ups are limited for patients following EA/TEF repair. The determination of the risk factors for the complicated evolution following EA/TEF repair may positively impact long-term prognoses. Much remains to be studied regarding this condition. This manuscript provides a literature review of the current knowledge regarding EA.

Pinheiro, Paulo Fernando Martins; Simoes e Silva, Ana Cristina; Pereira, Regina Maria

2012-01-01

246

Development of a Multicomponent Prediction Model for Acute Esophagitis in Lung Cancer Patients Receiving Chemoradiotherapy  

SciTech Connect

Purpose: To construct a model for the prediction of acute esophagitis in lung cancer patients receiving chemoradiotherapy by combining clinical data, treatment parameters, and genotyping profile. Patients and Methods: Data were available for 273 lung cancer patients treated with curative chemoradiotherapy. Clinical data included gender, age, World Health Organization performance score, nicotine use, diabetes, chronic disease, tumor type, tumor stage, lymph node stage, tumor location, and medical center. Treatment parameters included chemotherapy, surgery, radiotherapy technique, tumor dose, mean fractionation size, mean and maximal esophageal dose, and overall treatment time. A total of 332 genetic polymorphisms were considered in 112 candidate genes. The predicting model was achieved by lasso logistic regression for predictor selection, followed by classic logistic regression for unbiased estimation of the coefficients. Performance of the model was expressed as the area under the curve of the receiver operating characteristic and as the false-negative rate in the optimal point on the receiver operating characteristic curve. Results: A total of 110 patients (40%) developed acute esophagitis Grade {>=}2 (Common Terminology Criteria for Adverse Events v3.0). The final model contained chemotherapy treatment, lymph node stage, mean esophageal dose, gender, overall treatment time, radiotherapy technique, rs2302535 (EGFR), rs16930129 (ENG), rs1131877 (TRAF3), and rs2230528 (ITGB2). The area under the curve was 0.87, and the false-negative rate was 16%. Conclusion: Prediction of acute esophagitis can be improved by combining clinical, treatment, and genetic factors. A multicomponent prediction model for acute esophagitis with a sensitivity of 84% was constructed with two clinical parameters, four treatment parameters, and four genetic polymorphisms.

De Ruyck, Kim, E-mail: kim.deruyck@UGent.be [Department of Basic Medical Sciences, Ghent University, Ghent (Belgium); Sabbe, Nick [Department of Applied Mathematics, Biometrics and Process Control, Ghent University, Ghent (Belgium); Oberije, Cary [Department of Radiation Oncology (MAASTRO Clinic), Research Institute of Growth and Development, Maastricht University Medical Center, Maastricht (Netherlands); Vandecasteele, Katrien [Department of Radiation Oncology, Ghent University Hospital, Ghent (Belgium); Thas, Olivier [Department of Applied Mathematics, Biometrics and Process Control, Ghent University, Ghent (Belgium); De Ruysscher, Dirk; Lambin, Phillipe [Department of Radiation Oncology (MAASTRO Clinic), Research Institute of Growth and Development, Maastricht University Medical Center, Maastricht (Netherlands); Van Meerbeeck, Jan [Department of Respiratory Medicine, Ghent University Hospital, Ghent (Belgium); De Neve, Wilfried [Department of Radiation Oncology, Ghent University Hospital, Ghent (Belgium); Thierens, Hubert [Department of Basic Medical Sciences, Ghent University, Ghent (Belgium)

2011-10-01

247

A phase II trial of neoadjuvant IMRT-based chemoradiotherapy followed by one cycle of capecitabine for stage II/III rectal adenocarcinoma  

PubMed Central

Purpose Neoadjuvant chemoradiation has become the standard treatment in locally advanced rectal cancer (LARC) and improves local control. This study explored the feasibility of an intensified chemoradiation treatment followed by one cycle of capecitabine before surgery for LARC. Methods and materials Patients with histologically confirmed, newly diagnosed, locally advanced rectal adenocarcinoma (cT3-T4 and/or cN+) located within 12 cm of the anal verge were included in this study. Patients received intensity-modulated radiation therapy (IMRT) to the pelvis (total dose 44 Gy in 20 fractions), as well as concurrent oxaliplatin (50 mg/m2 d1 weekly) and capecitabine (625 mg/m2 b.i.d. d1–5 weekly). One cycle of capecitabine (1000 mg/m2 b.i.d. d1–14) was given two weeks after the completion of concomitant chemoradiation, and radical surgery was scheduled six weeks after chemoradiation. Results Between October 2007 and November 2008, a total of 42 patients were enrolled in the study (median age 51 years; 31 male). Of these, 38 underwent surgical resection and 4 refused radical surgery because of almost complete primary tumor regression and complete symptom relief after neoadjuvant therapy. Fifteen patients underwent sphincter-sparing lower anterior resection. Six patients had a pathological complete response (pCR). The incidence of grade 3 hematologic, gastro-intestinal, and skin toxicities were 4.7%, 14.3%, and 26.2%, respectively. Grade 4 toxicity was not observed. Surgical complications (incisional infection within 2–3 weeks after surgery) were observed in 5 patients. Good responders (defined as TRG 3–4) had a significant difference in DFS (81.6% vs. 16.8%, respectively; p = 0.000) and OS (83.9% vs. 40.7%, respectively; p = 0.007) compared to those who were evaluated as TRG 1–2. Conclusions Our study indicates that neoadjuvant chemoradiation followed by one cycle of capecitabine before surgery has a good treatment efficacy, with only mild toxicities associated with chemoradiation and acceptable surgical complications. Treatment response was an early surrogate marker and correlated to oncologic prognosis.

2013-01-01

248

Synchronized population oscillation of excitatory synaptic potentials dependent of calcium-induced calcium release in rat neocortex layer II/III neurons.  

PubMed

We examined the roles played by calcium-induced calcium release from ryanodine-sensitive calcium stores in induction of neocortical membrane potential oscillation by using caffeine, an agonist of ryanodine receptors. Intracellular recordings were made from neurons in layer II/III of rat visual cortex slices in a caffeine-containing medium. White matter stimulation initially evoked monophasic synaptic potentials. As low-frequency stimulation continued for over 10 min, an oscillating synaptic potential gradually became evoked, in which a paroxysmal depolarization shift was followed by a 8-10-Hz train of several depolarizing wavelets. This oscillating potential was not induced in a medium containing no caffeine with 2 or 0.5 mM [Mg2+](o). Under blockade of N-methyl-D-aspartate receptors, induction of this oscillating potential failed even with caffeine application. Experiments with the calcium store depletor, thapsigargin, revealed that this oscillating potential is induced in a manner dependent on intracellular calcium release. Dual intracellular recordings revealed that the oscillation was synchronized in pairs of layer II/III neurons. The oscillating potential was detectable by field potential recordings also, suggesting that the present oscillation seems to reflect a network property. PMID:11578624

Yoshimura, H; Sugai, T; Onoda, N; Segami, N; Kato, N

2001-10-01

249

Cadmium diruthenium(II,III) carbonates showing diverse magnetism behavior arising from variety configuration of [Ru2(CO3)4]n(3n-) layer.  

PubMed

Two hetero-metallic carbonates, namely KCd(H2O)3Ru2(CO3)4·4H2O (1) and KCd(H2O)3Ru2(CO3)4·3.5H2O (2), have been synthesized in a neutral aqueous solution. Both of the 3D dimensional structured complexes contain mixed-valent diruthenium(II,III) carbonate paddlewheel cores of Ru2(II,III)(CO3)4(3-) that are connected to each other in trans- or cis-modes by carbonate oxygen atoms, forming rectangular square-grid and isomeric parallelogram layers [Ru2(CO3)4]n(3n-) in 1 and 2, respectively. The reaction temperature is found to play an important role in directing the final products with particular topologies and their layered structural diversity is due to the various linking modes between the Ru2(CO3)4(3-) units. The magnetic studies show that ferromagnetic interactions are propagated between the diruthenium units in both complexes 1 and 2 but their magnetic properties differ at low temperatures, in which the trans linking mode parallelogram layer [Ru2(CO3)4]n(3n-) in complex 2 leads to long-range magnetic ordering below 4.0 K. However, no Curie ordering down to 1.8 K is detected for complex 1 containing the isomeric rectangle square-grid layer linking in the cis mode. PMID:23727751

Liu, Bin; Jia, Yan-Yan; Jin, Jin; Liu, Xue-Mei; Wang, Dan; Xue, Gang-Lin

2013-07-28

250

Successful treatment of esophageal cancer with transhiatal esophagectomy after heart transplantation.  

PubMed

A 55-year-old heart transplant recipient with reflux esophagitis presented for routine endoscopic surveillance of an area of Barrett's metaplasia initially seen 3 years previously. Esophagogastroduodenoscopy revealed adenocarcinoma at 33 cm from the incisors. The preoperative clinical stage was T1N0M0 by endoscopic ultrasound. Transhiatal esophagectomy was performed with R0 resection of the cancer, and the patient recovered uneventfully. Pathologic examination confirmed esophageal adenocarcinoma (T1N0M0) in Barrett's mucosa. The patient is doing well, and has no evidence of disease after 18 months. PMID:15276556

Gupta, Dipin; Macha, Mahender; Piacentino, Valentino; Singhal, Arun K; Sasken, Harvey F; Furukawa, Satoshi; Dempsey, Daniel T

2004-08-01

251

Concurrent Chemoradiotherapy for Esophageal Cancer With Malignant Fistula  

SciTech Connect

Background: We reviewed clinical results of chemoradiotherapy (CRT) in the treatment of patients with advanced esophageal cancer with fistulae that developed before or during CRT. Methods and Materials: The study group included 16 patients with fistulous esophageal cancer treated by means of CRT between 1999 and 2006. Nine patients had fistulae before CRT, whereas 7 developed fistulae during CRT. The group included 12 men and four women with a median age of 55 years (range, 37-77 years). There were 9 patients with Stage III disease and 7 with Stage IV disease. All tumors were squamous cell carcinomas. Two courses of concurrent chemotherapy were combined with radiation therapy; 60 Gy/30 fractions/7 weeks (1-week split). For 15 patients, low-dose protracted chemotherapy with 5-fluorouracil (250-300 mg/m{sup 2} x 14 days) and cisplatin (7 mg/m{sup 2} x 10 days) was administered, whereas full-dose cisplatin and 5-fluorouracil were administered to the remaining patient. Results: The planned dose of 60 Gy was delivered to 11 patients (69%), whereas radiation therapy was terminated early in 5 patients (40-58 Gy) because of acute toxicities, including two treatment-related deaths. Disappearance of fistulae was noted during or after CRT in 7 patients (44%). All three esophagomediastinal fistulae were closed, but only four of 13 esophagorespiratory fistulae were closed by CRT. For patients with Stage III, 1- and 2-year survival rates were 33% and 22%, respectively. Median survival time was 8.5 months. Conclusion: Despite significant toxicity, concurrent CRT appears effective at closing esophageal malignant fistulae.

Koike, Ryuta [Department of Radiation Oncology, Kinki University School of Medicine, Osaka (Japan); Nishimura, Yasumasa [Department of Radiation Oncology, Kinki University School of Medicine, Osaka (Japan)], E-mail: ynishi@med.kindai.ac.jp; Nakamatsu, Kiyoshi; Kanamori, Shuichi; Shibata, Toru [Department of Radiation Oncology, Kinki University School of Medicine, Osaka (Japan)

2008-04-01

252

ACG Practice Guidelines: Esophageal Reflux Testing  

Microsoft Academic Search

Investigations and technical advances have enhanced our understanding and management of gastroesophageal reflux disease. The recognition of the prevalence and importance of patients with endoscopy-negative reflux disease as well as those refractory to proton pump inhibitor therapy have led to an increasing need for objective tests of esophageal reflux. Guidelines for esophageal reflux testing are developed under the auspices of

Ikuo Hirano; Joel E. Richter

2007-01-01

253

Endoscopic diverticulotomy for symptomatic pediatric esophageal diverticula  

Microsoft Academic Search

There have so far been few reports on esophageal diverticulum in children. We experienced two symptomatic pediatric cases with esophageal diverticulum. Our cases manifested high fever and dysphagia with chest pain during swallowing. The patients underwent endoscopic diverticulotomy. The septum between the diverticulum and the esophagus was cut using the argon plasma coagulation (APC 3000) system. We recommend an endoscopic diverticulotomy

Y. Nishimoto; T. Taguchi; K. Ogita; M. Hashizume; S. Suita

2005-01-01

254

Epidemiology of gastro-esophageal reflux disease  

Microsoft Academic Search

Gastro-esophageal reflux disease encompasses a spectrum of disorders in which gastric reflux leads to symptoms and\\/or damage to the esophageal mucosa. Although a common problem in clinical practice, our understanding of the pathophysiology of the condition has not been matched by our knowledge of its epidemiology and natural history. This review examines some of the difficulties inherent in epidemiological studies

P. J. Howard; R. C. Heading

1992-01-01

255

Radiation Therapy for Esophageal Cancer in Japan: Results of the Patterns of Care Study 1999-2001  

SciTech Connect

Purpose: To describe patient characteristics and the process of radiotherapy (RT) for patients with esophageal cancer treated between 1999 and 2001 in Japan. Methods and Materials: The Japanese Patterns of Care Study (PCS) Working Group conducted a third nationwide survey of 76 institutions. Detailed information was accumulated on 621 patients with thoracic esophageal cancer who received RT. Results: The median age of patients was 68 years. Eighty-eight percent were male, and 12% were female. Ninety-nine percent had squamous cell carcinoma histology. Fifty-five percent had the main lesion in the middle thoracic esophagus. Fourteen percent had clinical Stage 0-I disease, 32% had Stage IIA-IIB, 43% had Stage III, and 10% had Stage IV disease. Chemotherapy was given to 63% of patients; 39% received definitive chemoradiotherapy (CRT) without surgery and 24% pre- or postoperative CRT. Sixty-two percent of the patients aged {>=}75 years were treated with RT only. Median total dose of external RT was 60 Gy for definitive CRT patients, 60 Gy for RT alone, and 40 Gy for preoperative CRT. Conclusions: This PCS describes general aspects of RT for esophageal cancer in Japan. Squamous cell carcinoma accounted for the majority of patients. The standard total external RT dose for esophageal cancer was higher in Japan than in the United States. Chemoradiotherapy had become common for esophageal cancer treatment, but patients aged {>=}75 years were more likely to be treated by RT only.

Kenjo, Masahiro [Division of Radiation Oncology, Hiroshima University Hospital, Hiroshima (Japan)], E-mail: kenjom@hiroshima-u.ac.jp; Uno, Takashi [Department of Radiation Oncology, Chiba University, Graduate School of Medicine, Chiba (Japan); Murakami, Yuji; Nagata, Yasushi [Division of Radiation Oncology, Hiroshima University Hospital, Hiroshima (Japan); Oguchi, Masahiko [Department of Medical Engineering, Osaka University Medical School, Osaka (Japan); Saito, Susumu; Numasaki, Hodaka; Teshima, Teruki [Department of Radiation Oncology, Cancer Institute Ariake Hospital, Tokyo (Japan); Mitsumori, Michihide [Department of Radiation Oncology, Kyoto University, Graduate School of Medicine, Kyoto (Japan)

2009-10-01

256

Increased FDG activity in a dermatofibroma in esophageal cancer patient.  

PubMed

PET using the radiotracer (18)F-FDG is used for staging patients with esophageal cancer. Nonmalignant conditions, mainly inflammation and some benign tumors, however, can cloud the clinical picture by taking up FDG and producing a false-positive result. We report the case of a 46 year-old man with squamous cell carcinoma of the thoracic esophagus who underwent combined PET/CT and had false-positive uptake in a chest wall dermatofibroma. Dermatofibroma is a benign skin lesion with a characteristic large presence of fibroblasts and macrophages. Macrophage uptake of FDG is likely responsible for the false-positive result on PET/CT. PMID:23357820

Bingham, Brigid A; Hatef, Daniel A; Chevez-Barrios, Patricia; Blackmon, Shanda H; Kim, Min P

2013-03-01

257

[Eosinophilic esophagitis: the diagnostic contribution of pathology].  

PubMed

Eosinophilic esophagitis is a chronic, clinically and histologically defined, inflammatory condition of the esophagus. The histological hallmark of eosinophilic esophagitis is a relevant, often patchy infiltration of the esophageal mucosa with eosinophils. In a consensus report a threshold value of approximately 120 eosinophils per mm(2) was arbitrarily fixed as a diagnostic criterion. Noteworthy for the quantification of the eosinophilic infiltration are several technical facts, for instance size and covering extent of the biopsy specimen of the high-power field (hpf) and quality of embedding of biopsy specimens have to be considered. In order to establish the histological diagnosis several additional abnormalities must be included in the assessment and gastrointestinal reflux disease is the main differential diagnosis of eosinophilic esophagitis. Finally it is emphasized that for an affirmative diagnosis of eosinophilic esophagitis, in addition to the histological findings the clinical facts must be included. PMID:23483314

Bussmann, C; Straumann, A

2013-03-01

258

Progress on materials and scaffold fabrications applied to esophageal tissue engineering.  

PubMed

The mortality rate from esophageal disease like atresia, carcinoma, tracheoesophageal fistula, etc. is increasing rapidly all over the world. Traditional therapies such as surgery, radiotherapy or chemotherapy have been met with very limited success resulting in reduced survival rate and quality of patients' life. Tissue-engineered esophagus, a novel substitute possessing structure and function similar to native tissue, is believed to be an effective therapy and a promising replacement in the future. However, research on esophageal tissue engineering is still at an early stage. Considerable research has been focused on developing ideal scaffolds with optimal materials and methods of fabrication. This article gives a review of materials and scaffold fabrications currently applied in esophageal tissue engineering research. PMID:23498206

Shen, Qiuxiang; Shi, Peina; Gao, Mongna; Yu, Xuechan; Liu, Yuxin; Luo, Ling; Zhu, Yabin

2013-02-04

259

The Early Use of PET-CT Alters the Management of Patients with Esophageal Cancer  

Microsoft Academic Search

Introduction  The routine use of positron emission tomography–computed tomography (PET-CT) in the staging of patients with esophageal carcinoma\\u000a remains contentious, with conflicting reports of its benefit. In our unit, PET-CT has been used routinely in the staging of\\u000a all patients considered for radical therapy (surgery or chemoradiotherapy). Our aim was to determine the frequency with which\\u000a PET-CT influenced decision making in

R. N. Williams; S. S. Ubhi; C. D. Sutton; A. L. Thomas; J. J. Entwisle; D. J. Bowrey

2009-01-01

260

Studies on the mechanism of esophagitis-induced lower esophageal sphincter hypotension in cats.  

PubMed

Perfusion of 0.1 n HC1 5 cm above the lower esophageal sphincter (LES) in cats for 30 min on 4 consecutive days produced biopsy-documented esophagitis and marked decreases in LES pressure. Using this model the effects of experimental esophagitis on the LES response to edrophonium, pentagastrin, and bethanechol were determined. The sphincter response to both edrophonium and pentagastrin after esophagitis was induced was significantly less than preperfusion responses. When the esophagitis had resolved, the pressure response to edrophonium and pentagastrin returned to preperfusion levels. In contrast, the sphincter response to bethanechol during esophagitis was not different from the preperfusion response and remained unchanged after resolution of the esophagitis. Lower esophageal smooth muscle taken from cats with active esophagitis appeared normal by both light and electron microscopy. These studies indicate that besides decreasing resting LES tone, esophageal inflammation causes functional impairment of a cholinergic mechanism regulating LES pressure. In contrast, the smooth muscle appears to be unaffected by inflammation despite the LES hypotension. PMID:1278649

Higgs, R H; Castell, D O; Eastwood, G L

1976-07-01

261

Endoscopic management of esophageal varices.  

PubMed

The rupture of gastric varices results in variceal hemorrhage, which is one the most lethal complications of cirrhosis. Endoscopic therapies for varices aim to reduce variceal wall tension by obliteration of the varix. The two principal methods available for esophageal varices are endoscopic sclerotherapy (EST) and band ligation (EBL). The advantages of EST are that it is cheap and easy to use, and the injection catheter fits through the working channel of a diagnostic gastroscope. Endoscopic variceal ligation obliterates varices by causing mechanical strangulation with rubber bands. The following review aims to describe the utility of EBL and EST in different situations, such as acute bleeding, primary and secondary prophylaxis. PMID:22816012

Poza Cordon, Joaquin; Froilan Torres, Consuelo; Burgos García, Aurora; Gea Rodriguez, Francisco; Suárez de Parga, Jose Manuel

2012-07-16

262

Supradiaphragmatic correction of esophageal reflux strictures.  

PubMed Central

Intragastric pressure measurements and cineradiographic contrast studies were done in monkeys in order to determine the pressure at which esophageal reflux occurred. Antireflux operative procedures were performed above and below the diaphragm, and the results compared. The Nissen fundoplication proved to be the most effective type of mechanical antireflux valve and worked equally well placed above and below the diaphragm. Of 200 consecutive adult patients undergoing operative correction of esophageal reflux, 19 had severe esophageal strictures. Through a transthoracic approach, two patients had subdiaphragmatic Nissen fundoplications, one with adenocarcinoma of the esophagus had an esophageal resection, and 16 had supradiaphragmatic Nissen fundoplications; those 16 patients form the basis of this report. No patients died; superficial, temporary esophageal ulcerations developed in two. Follow-up times have ranged from six months to eight years; the results in all cases have been good. Experimental and clinical evidence supports the belief that this less radical approach is the treatment of choice in the management of severe esophageal strictures secondary to reflux esophagitis. Images Fig. 1. Fig. 2. Figs. 3. and 4. Figs. 5-7. Figs. 8. and 9. Fig. 10. Figs. 11. and 12.

Pennell, T C

1981-01-01

263

Helicobacter pylori Protection Against Reflux Esophagitis  

PubMed Central

Background and Aim Negative association has been reported between presence of Helicobacter pylori and developing gastroesophageal reflux disease (GERD) and its complications. The aim of this study was to determine whether H. pylori (HP) can be protective against GERD in an African American (AA) population. Methods From 2004 to 2007, we studied 2,020 cases; esophagitis (58), gastritis (1,558), both esophagitis and gastritis (363) and a normal control group (41). We collected their pathology and endoscopy unit reports. HP status was determined based on staining of gastric biopsy. Results HP data was available for 79 % (1,611) of the cases. The frequency of HP positivity in gastritis patients was 40 % (506), in esophagitis patients 4 % and in normal controls 34 % (11), while HP was positive in 34 % of the patients with both esophagitis and gastritis. After adjusting for effects of age and sex, odds ratio of HP was 0.06 (95 % CI 0.01–0.59; P value = 0.01) for the esophagitis group versus the normal group. Conclusions Our results show H. pylori has a significant negative association with esophagitis in AAs which may point to a protective role of H. pylori in the pathogenesis of esophagitis. In addition, H. pylori may be the reason for the low GERD complications in AAs.

Entezari, Omid; Nouraie, Mehdi; Dowlati, Ehsan; Frederick, Wayne; Woods, Alfreda; Lee, Edward; Brim, Hassan; Smoot, Duane T.; Ghadyari, Firoozeh; Kamangar, Farin; Razjouyan, Hadie

2013-01-01

264

Further Study of the Reaction of Fe2+ with CN?: Synthesis and Characterization of cis and trans [FeII,III(CN)4L2]n? Complexes  

PubMed Central

The reaction of Fe2+ with CN?, which was first performed in 1704, has been used to synthesize a new series of basic [FeII,III(CN)4L2]n? complexes where L is a monodentate ligand.. Trans-Na2[FeII(CN)4(DMSO)2] and cis-[NEt4]2[FeII(CN)4(pyridine)2] are synthesized by the direct reaction of FeCl2 with 4 equiv of CN? in DMSO or pyridine. Air oxidation of the latter compound gives cis-[NEt4][FeIII(CN)4(pyridine)2]. The non-cyanide ligands in these complexes undergo facile ligand exchange reactions with solvent. Reaction of cis-[NEt4]2[FeIII(CN)4(pyridine)2] with CO at RT gives trans-[NEt4]2[FeII(CN)4(pyridine)(CO)].

Chiarella, Gina M.; Melgarejo, Doris Y.; Koch, Stephen A.

2008-01-01

265

New Sequence Variants in HLA Class II/III Region Associated with Susceptibility to Knee Osteoarthritis Identified by Genome-Wide Association Study  

PubMed Central

Osteoarthritis (OA) is a common disease that has a definite genetic component. Only a few OA susceptibility genes that have definite functional evidence and replication of association have been reported, however. Through a genome-wide association study and a replication using a total of ?4,800 Japanese subjects, we identified two single nucleotide polymorphisms (SNPs) (rs7775228 and rs10947262) associated with susceptibility to knee OA. The two SNPs were in a region containing HLA class II/III genes and their association reached genome-wide significance (combined P?=?2.43×10?8 for rs7775228 and 6.73×10?8 for rs10947262). Our results suggest that immunologic mechanism is implicated in the etiology of OA.

Nakajima, Masahiro; Takahashi, Atsushi; Kou, Ikuyo; Rodriguez-Fontenla, Cristina; Gomez-Reino, Juan J.; Furuichi, Tatsuya; Dai, Jin; Sudo, Akihiro; Uchida, Atsumasa; Fukui, Naoshi; Kubo, Michiaki; Kamatani, Naoyuki; Tsunoda, Tatsuhiko; Malizos, Konstantinos N.; Tsezou, Aspasia; Gonzalez, Antonio; Nakamura, Yusuke; Ikegawa, Shiro

2010-01-01

266

Fine structures in refractive index of sapphire at the L(II,III) absorption edge of aluminum determined by soft x-ray resonant reflectivity.  

PubMed

The optical constants of sapphire crystal (?-Al(2)O(3)) and amorphous Al(2)O(3) in the soft x-ray region (67-85 eV) around the aluminum LII,III absorption edge (73.1 eV) are determined by angle-dependent x-ray reflectivity. The differences between the optical constant values of both the samples are discussed. The fine structures obtained in the absorption of crystalline sapphire are explained. An absorption feature at 70.2 eV is observed for the first time for crystalline alumina. Both datasets are compared to the tabulated values of Henke et al. [At. Data Nucl. Data Tables 54, 181 (1993)], Weaver et al. [Physik Daten, Physics Data: Optical Properties of Metals (Fach-information zentrum, 1981), Vols. 18-1 and 18-2], and [Handbook of Optical Constants of Solids II (Academic, 1991)]. PMID:23089798

Das, Arijeet; Gupta, Rajkumar K; Modi, Mohammed H; Mukherjee, Chandrachur; Rai, Sanjay K; Bose, Aniruddha; Ganguli, Tapas; Joshi, Satish C; Lodha, Gyan S; Deb, Sudip K

2012-10-20

267

[Oral blastomycosis, laryngeal papillomatosis and esophageal tuberculosis].  

PubMed

Esophageal involvement is an extremely rare complication of tuberculosis even in countries with high prevalence of infection. We report the case of a 57 year-old hiv-seronegative patient with simultaneous diagnoses of oral blastomycosis and laryngeal papillomatosis. Both were confirmed by anatomopathological analysis. The esophageal biopsy revealed granulomatous esophagitis with necrosis and ziehl-neelsen stain showed acid-fast alcohol resistant bacilli suggestive of tuberculosis. The patient's history included pulmonary tuberculosis twice and previous abandonment of therapy. Thus, it was necessary to use oral itraconazole combined with second-line anti-tuberculosis drugs administered through a gastrostomy tube. The clinical development was favorable. PMID:22858774

Montoya, Manuel; Chumbiraico, Robert; Ricalde, Melvin; Cazorla, Ernesto; Hernández-Córdova, Gustavo

2012-06-01

268

Systemic treatment after whole-brain radiotherapy may improve survival in RPA class II/III breast cancer patients with brain metastasis.  

PubMed

Whole brain radiotherapy (WBRT) is the most widely used treatment for brain metastasis (BM), especially for patients with multiple intracranial lesions. The purpose of this study was to examine the efficacy of systemic treatments following WBRT in breast cancer patients with BM who had different clinical characteristics, based on the classification of the Radiation Therapy Oncology Group recursive partitioning analysis (RPA) and the breast cancer-specific Graded Prognostic Assessment (Breast-GPA). One hundred and one breast cancer patients with BM treated between 2006 and 2010 were analyzed. The median interval between breast cancer diagnosis and identification of BM in the triple-negative patients was shorter than in the luminal A subtype (26 vs. 36 months, respectively; P = 0.021). Univariate analysis indicated that age at BM diagnosis, Karnofsky performance status/recursive partitioning analysis (KPS/RPA) classes, number of BMs, primary tumor control, extracranial metastases and systemic treatment following WBRT were significant prognostic factors for overall survival (OS) (P < 0.05). Multivariate analysis revealed that KPS/RPA classes and systemic treatments following WBRT remained the significant prognostic factors for OS. For RPA class I, the median survival with and without systemic treatments following WBRT was 25 and 22 months, respectively (P = 0.819), while for RPA class II/III systemic treatments significantly improved OS from 7 and 2 months to 11 and 5 months, respectively (P < 0.05). Our results suggested that triple-negative patients had a shorter interval between initial diagnosis and the development of BM than luminal A patients. Systemic treatments following WBRT improved the survival of RPA class II/III patients. PMID:23743596

Zhang, Qian; Chen, Jian; Yu, Xiaoli; Ma, Jinli; Cai, Gang; Yang, Zhaozhi; Cao, Lu; Chen, Xingxing; Guo, Xiaomao; Chen, Jiayi

2013-06-07

269

FKBP12 modulation of the binding of the skeletal ryanodine receptor onto the II-III loop of the dihydropyridine receptor.  

PubMed Central

In skeletal muscle, excitation-contraction coupling involves a functional interaction between the ryanodine receptor (RyR) and the dihydropyridine receptor (DHPR). The domain corresponding to Thr(671)-Leu(690) of the II-III loop of the skeletal DHPR alpha(1)-subunit is able to regulate RyR properties and calcium release from sarcoplasmic reticulum, whereas the domain corresponding to Glu(724)-Pro(760) antagonizes this effect. Two peptides, covering these sequences (peptide A(Sk) and C(Sk), respectively) were immobilized on polystyrene beads. We demonstrate that peptide A(Sk) binds to the skeletal isoform of RyR (RyR1) whereas peptide C(Sk) does not. Using surface plasmon resonance detection, we show that 1) domain Thr(671)-Leu(690) is the only sequence of the II-III loop binding with RyR1 and 2) the interaction of peptide A(Sk) with RyR1 is not modulated by Ca(2+) (pCa 9-2) nor by Mg(2+) (up to 10 mM). In contrast, this interaction is strongly potentiated by the immunophilin FKBP12 (EC(50) = 10 nM) and inhibited by both rapamycin (IC(50) = 5 nM) and FK506. Peptide A(Sk) induces a 300% increase of the opening probability of the RyR1 incorporated in lipid bilayer. Removal of FKBP12 from RyR1 completely abolishes this effect of domain A(Sk) on RyR1 channel behavior. These results demonstrate a direct interaction of the RyR1 with the discrete domain of skeletal DHPR alpha(1)-subunit corresponding to Thr(671)-Leu(690) and show that the association of FKBP12 with RyR1 specifically modulates this interaction.

O'Reilly, Fiona M; Robert, Mylene; Jona, Istvan; Szegedi, Csaba; Albrieux, Mireille; Geib, Sandrine; De Waard, Michel; Villaz, Michel; Ronjat, Michel

2002-01-01

270

Overexpression of metastasis-associated in colon cancer-1 associated with poor prognosis in patients with esophageal cancer.  

PubMed

Recent studies have shown that expression of metastasis-associated in colon cancer-1(MACC1) is observed in different types of cancer and plays an important role in tumor metastasis. However, the expression of MACC1 and its possible role in esophageal cancer remains unknown. In this study, we determined the expression of MACC1 in esophageal cancer by utilizing immunohistochemistry and analyzed the relationship between the expression and esophageal cancer prognosis. Immunohistochemistry results showed that 47 of 85 cancer lesions (55.2 %) were stained positive, and high expression of MACC1 was correlated with the node metastasis and TNM stage (P?esophageal cancer. These findings suggested that high expression of MACC1 was correlated with progression and metastasis of esophageal cancer and might serve as a novel prognostic marker for patients with esophageal cancer. PMID:23737034

Zhu, Mingchen; Xu, Yijun; Mao, Xuelian; Gao, Yanfang; Shao, Lijia; Yan, Feng

2013-06-05

271

Expression of HIWI in human esophageal squamous cell carcinoma is significantly associated with poorer prognosis  

PubMed Central

Background HIWI, the human homologue of Piwi family, is present in CD34+ hematopoietic stem cells and germ cells, but not in well-differentiated cell populations, indicating that HIWI may play an impotent role in determining or maintaining stemness of these cells. That HIWI expression has been detected in several type tumours may suggest its association with clinical outcome in cancer patients. Methods With the methods of real-time PCR, western blot, immunocytochemistry and immunohistochemistry, the expression of HIWI in three esophageal squamous cancer cell lines KYSE70, KYSE140 and KYSE450 has been characterized. Then, we investigated HIWI expression in a series of 153 esophageal squamous cell carcinomas using immunohistochemistry and explored its association with clinicopathological features. Results The expression of HIWI was observed in tumour cell nuclei or/and cytoplasm in 137 (89.5%) cases, 16 (10.5%) cases were negative in both nuclei and cytoplasm. 86 (56.2%) were strongly positive in cytoplasm, while 49 (32.0%) were strongly positive in nuclei. The expression level of HIWI in cytoplasm of esophageal cancer cells was significantly associated with histological grade (P = 0.011), T stage (P = 0.035), and clinic outcome (P < 0.001), while there was no correlation between the nuclear HIWI expression and clinicopathological features. Conclusion The expression of HIWI in the cytoplasm of esophageal cancer cells is significantly associated with higher histological grade, clinical stage and poorer clinical outcome, indicating its possible involvement in cancer development.

2009-01-01

272

Evaluation of esophageal motor function in clinical practice.  

PubMed

Esophageal motor function is highly coordinated between central and enteric nervous systems and the esophageal musculature, which consists of proximal skeletal and distal smooth muscle in three functional regions, the upper and lower esophageal sphincters, and the esophageal body. While upper endoscopy is useful in evaluating for structural disorders of the esophagus, barium esophagography, radionuclide transit studies, and esophageal intraluminal impedance evaluate esophageal transit and partially assess motor function. However, esophageal manometry is the test of choice for the evaluation of esophageal motor function. In recent years, high-resolution manometry (HRM) has streamlined the process of acquisition and display of esophageal pressure data, while uncovering hitherto unrecognized esophageal physiologic mechanisms and pathophysiologic patterns. New algorithms have been devised for analysis and reporting of esophageal pressure topography from HRM. The clinical value of HRM extends to the pediatric population, and complements preoperative evaluation prior to foregut surgery. Provocative maneuvers during HRM may add to the assessment of esophageal motor function. The addition of impedance to HRM provides bolus transit data, but impact on clinical management remains unclear. Emerging techniques such as 3-D HRM and impedance planimetry show promise in the assessment of esophageal sphincter function and esophageal biomechanics. PMID:23336590

Gyawali, C P; Bredenoord, A J; Conklin, J L; Fox, M; Pandolfino, J E; Peters, J H; Roman, S; Staiano, A; Vaezi, M F

2013-02-01

273

A Comparison Between Low-Volume Referring Regional Centers and a High-Volume Referral Center in Quality of Preoperative Metastasis Detection in Esophageal Carcinoma  

Microsoft Academic Search

BACKGROUND AND AIM:An inverse correlation between hospital volume and esophageal resection mortality has been reported. In this study, we compared the quality of preoperative metastasis detection between a high-volume referral center with that of low-volume referring regional centers.METHODS:In 573 patients diagnosed with esophageal cancer (1994–2003), the results of preoperative staging investigations (CT-scan, ultrasound of abdomen and neck, and chest x-ray)

Evelyn P. M. van Vliet; Marinus J. C. Eijkemans; Ernst J. Kuipers; John J. Hermans; Ewout W. Steyerberg; Hugo W. Tilanus; Ate van der Gaast; Peter D. Siersema

2006-01-01

274

Esophageal ulceration induced by intracavitary irradiation for esophageal carcinoma  

SciTech Connect

Twenty-two patients with esophageal carcinoma had no local recurrence after external and intracavitary radiation treatment, but all developed ulcers in the field of intracavitary irradiation. Ten were linear ulcers that appeared 3-12 months after radiation treatment (mean, 5.3 months); the other 12 were the long circumferential type and appeared 1-8 months after irradiation (mean, 3.7 months). Esophagobronchial fistulae developed in two cases in which deep ulcer had been found between the completion of external irradiation and the beginning of intracavitary irradiation. In these cases with deep ulcer, intracavitary irradiation should not be done. For patients receiving intracavitary radiation, the total dosage should be less than 20 Gy.

Hishikawa, Y.; Tanaka, S.; Miura, T.

1984-08-01

275

Utility and standards in esophageal manometry.  

PubMed

Esophageal manometry is a specialized procedure used to evaluate lower and upper esophageal sphincter pressure, esophageal body contraction amplitude, and peristaltic sequence. The procedure is clinically useful in evaluation of a patient with nonstructural dysphagia, unexplained or noncardiac chest pain, a compendium of symptoms suggested because of gastroesophageal reflux disease, and in the preoperative evaluation for antireflux surgery. Manometric findings in 95 normal subjects evenly distributed across age groups were reported in 1987, and are the values still used in our and most laboratories today. The subsequent review will offer our "view" on the clinical utility of esophageal manometry, on the basis of years of experience and performance techniques that have remained constant over decades. PMID:18364580

Katz, Philip O; Menin, Richard A; Gideon, R Matthew

276

21 CFR 878.3610 - Esophageal prosthesis.  

Code of Federal Regulations, 2013 CFR

...SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Prosthetic Devices § 878.3610 Esophageal...rigid, flexible, or expandable tubular device made of a plastic, metal, or polymeric material that is...

2013-04-01

277

Tracheoesophageal fistula and esophageal atresia repair  

MedlinePLUS

Tracheoesophageal fistula and esophageal atresia repair is surgery to repair two birth defects in your esophagus and trachea. ... not connect with the lower esophagus and stomach. Tracheoesophageal fistula (TEF) is a connection between the upper part ...

278

Aurora kinase A (AURKA) and never in mitosis gene A-related kinase 6 (NEK6) genes are upregulated in erosive esophagitis and esophageal adenocarcinoma.  

PubMed

Gastroesophageal reflux disease is a risk factor for esophageal adenocarcinoma yet studies that have investigated the relationship between erosive esophagitis and esophageal adenocarcinoma have usually focused on symptom-related evidence or polymorphisms. There are no epigenetic gene expression studies on this topic. In this study, we aimed to evaluate the relationship between erosive esophagitis and esophageal adenocarcinoma to identify whether there is a genetic predisposition for esophageal adenocarcinoma. The Human Epigenetic Chromatin Modification Enzyme RT(2) Profiler(™) PCR array (PAHS-085A) was used to detect the expression of 84 key genes encoding enzymes. This was carried out prospectively for samples from 60 patients (20 patients as a control group, 20 patients with erosive esophagitis and 20 patients with esophageal adenocarcinoma). AURKA, AURKB, NEK6 were expressed at significantly higher levels in esophageal adenocarcinoma compared to the control group. MBD2 was expressed at significantly lower levels in the esophageal adenocarcinoma group compared to the control group. AURKA, AURKC, HDAC9 and NEK6 were expressed at significantly higher levels in erosive esophagitis compared to the control group. There was no difference in upregulated gene expression between the erosive esophagitis and esophageal adenocarcinoma. MBD2 was significantly downregulated in esophageal adenocarcinoma compared to erosive esophagitis. NEK6 and AURKA were significantly upregulated in esophageal adenocarcinoma and erosive esophagitis compared to the control group. This is a novel study on the genetic predisposition for erosive esophagitis and esophageal adenocarcinoma. AURKA and NEK6 are two promising genetic markers for erosive esophagitis and esophageal adenocarcinoma. PMID:23060919

Kasap, Elmas; Boyacioglu, Seda Örenay; Korkmaz, Mehmet; Yuksel, Elif Saritas; Unsal, Belkis; Kahraman, Erkan; Ozütemiz, Omer; Yuceyar, Hakan

2012-04-25

279

Aurora kinase A (AURKA) and never in mitosis gene A-related kinase 6 (NEK6) genes are upregulated in erosive esophagitis and esophageal adenocarcinoma  

PubMed Central

Gastroesophageal reflux disease is a risk factor for esophageal adenocarcinoma yet studies that have investigated the relationship between erosive esophagitis and esophageal adenocarcinoma have usually focused on symptom-related evidence or polymorphisms. There are no epigenetic gene expression studies on this topic. In this study, we aimed to evaluate the relationship between erosive esophagitis and esophageal adenocarcinoma to identify whether there is a genetic predisposition for esophageal adenocarcinoma. The Human Epigenetic Chromatin Modification Enzyme RT2 Profiler™ PCR array (PAHS-085A) was used to detect the expression of 84 key genes encoding enzymes. This was carried out prospectively for samples from 60 patients (20 patients as a control group, 20 patients with erosive esophagitis and 20 patients with esophageal adenocarcinoma). AURKA, AURKB, NEK6 were expressed at significantly higher levels in esophageal adenocarcinoma compared to the control group. MBD2 was expressed at significantly lower levels in the esophageal adenocarcinoma group compared to the control group. AURKA, AURKC, HDAC9 and NEK6 were expressed at significantly higher levels in erosive esophagitis compared to the control group. There was no difference in upregulated gene expression between the erosive esophagitis and esophageal adenocarcinoma. MBD2 was significantly downregulated in esophageal adenocarcinoma compared to erosive esophagitis. NEK6 and AURKA were significantly upregulated in esophageal adenocarcinoma and erosive esophagitis compared to the control group. This is a novel study on the genetic predisposition for erosive esophagitis and esophageal adenocarcinoma. AURKA and NEK6 are two promising genetic markers for erosive esophagitis and esophageal adenocarcinoma.

KASAP, ELMAS; BOYACIOGLU, SEDA ORENAY; KORKMAZ, MEHMET; YUKSEL, ELIF SARITAS; UNSAL, BELKIS; KAHRAMAN, ERKAN; OZUTEMIZ, OMER; YUCEYAR, HAKAN

2012-01-01

280

Necrotizing esophagitis presenting as a black esophagus  

Microsoft Academic Search

.   A case of necrotizing esophagitis discovered during upper endoscopy is described. An 88-year-old woman was admitted to our\\u000a hospital with complaints of multiple episodes of coffee ground emesis and dysphagia over 3 months. Ischemia is proposed as\\u000a the etiology of necrotizing esophagitis on the basis of the patient's significant cardiac history, her age, and low-flow state.

R. Obermeyer; K. Kasirajan; V. Erzurum; D. Chung

1998-01-01

281

Delayed fistulization from esophageal replacement surgery.  

PubMed

We present two patients who developed delayed fistulization following esophageal replacement surgery. The first is a 13-year-old child who, at the age of 3 years, underwent a trans-mediastinal colonic esophageal replacement for a refractory corrosive injury followed by a retrosternal reverse gastric tube after an early catastrophic leak. Ten years later, he presented with a history of intermittent chest pain for 6 months. He developed a tension pneumo-pericardial tamponade caused by a fistula between gastric tube and pericardium. He recovered after sternotomy. The second was born prematurely with type C esophageal atresia and other malformations. After esophageal anastomosis, he developed a refractory stricture that was resected at 10 months. Despite a fundoplication at 4 years, the recurrent esophageal stricture required resection at 14 years, accomplished by mobilizing the stomach into the chest through a left thoracoabdominal incision. The postoperative course was complicated by a gastric leak in the chest with empyema, but the patient recovered and was able to eat. Five years later, he underwent an anterior spinal fusion to correct a worsening kyphoscoliosis. Postoperatively, he developed an ARDS picture, leakage of air through the gastrostomy, and a fatal pulmonary hemorrhage secondary to a gastro-bronchial fistula. Fistulization from esophageal replacement surgery represents a rare long-term complication that pediatric surgeons need to be aware of. PMID:19349000

Abdalwahab, Ahmed; Al Namshan, Mohammed; Al Rabeeah, Abdullah; Laberge, Jean-Martin

2009-05-01

282

Effect of total laryngectomy on esophageal motility  

SciTech Connect

Total laryngectomy for cancer can result in dysphagia and altered esophageal motility. Manometric changes in the upper esophageal sphincter (UES), and in proximal and distal esophageal function have been reported. However, most studies have failed to take into account radiation therapy and appropriate controls. We selected ten male patients (54.3 +/- 1.9 yr) for longitudinal manometric evaluation prior to laryngectomy then at two weeks and again six months later. No patient received preoperative radiation therapy, had a previous history of esophageal surgery, or developed a postoperative wound infection or fistula. Seven of ten patients had positive nodes and received 6,000-6,600 rads postoperative radiation therapy. Preoperatively 4 of 10 patients complained of dysphagia which did not significantly change following surgery and radiation. Two of three patients who did not complain of dysphagia preoperatively and received radiation postoperatively developed dysphagia. No patient without dysphagia preoperatively who received no radiation therapy developed symptoms. Our studies show that laryngectomy causes alterations in the UES resting and peak pressures but not in the proximal or distal esophagus, or the lower esophageal sphincter. These data also imply radiation therapy may be associated with progressive alterations in motility and symptomatology. Further study regarding the effects of radiation on esophageal motility and function are urged.

Hanks, J.B.; Fisher, S.R.; Meyers, W.C.; Christian, K.C.; Postlethwait, R.W.; Jones, R.S.

1981-01-01

283

Epigenetic biomarkers in esophageal cancer.  

PubMed

The aberrant DNA methylation of tumor suppressor genes is well documented in esophageal cancer, including adenocarcinoma (EAC) and squamous cell carcinoma (ESCC) as well as in Barrett's esophagus (BE), a pre-malignant condition that is associated with chronic acid reflux. BE is a well-recognized risk factor for the development of EAC, and consequently the standard of care is for individuals with BE to be placed in endoscopic surveillance programs aimed at detecting early histologic changes that associate with an increased risk of developing EAC. Yet because the absolute risk of EAC in individuals with BE is minimal, a clinical need in the management of BE is the identification of additional risk markers that will indicate individuals who are at a significant absolute risk of EAC so that they may be subjected to more intensive surveillance. The best currently available risk marker is the degree of dysplasia in endoscopic biopsies from the esophagus; however, this marker is suboptimal for a variety of reasons. To date, there are no molecular biomarkers that have been translated to widespread clinical practice. The search for biomarkers, including hypermethylated genes, for either the diagnosis of BE, EAC, or ESCC or for risk stratification for the development of EAC in those with BE is currently an area of active research. In this review, we summarize the status of identified candidate epigenetic biomarkers for BE, EAC, and ESCC. Most of these aberrantly methylated genes have been described in the context of early detection or diagnostic markers; others might prove useful for estimating prognosis or predicting response to treatment. Finally, special attention will be paid to some of the challenges that must be overcome in order to develop clinically useful esophageal cancer biomarkers. PMID:22406828

Kaz, Andrew M; Grady, William M

2012-03-01

284

Sustained esophageal contraction: A marker of esophageal chest pain identified by intraluminal ultrasonography  

Microsoft Academic Search

Background & Aims: Intraluminal pressure recording systems have not demonstrated predictable esophageal motor correlates of unexplained chest pain. This study used continuous high-frequency intraluminal ultrasonography to characterize esophageal contraction at the time of spontaneous and provoked chest pain. Methods: Intraluminal pressure, pH, and ultrasound images of the esophagus were recorded for a maximum of 24 hours in 10 subjects with

David H. Balaban; Yoshihiro Yamamoto; Jianmin Liu; Nonko Pehlivanov; Ralph Wisniewski; Dennis DeSilvey; Ravinder K. Mittal

1999-01-01

285

Eosinophilic esophagitis after esophageal atresia: is there an association? Case presentation and literature review.  

PubMed

Eosinophilic esophagitis (EoE) is a relatively new condition resulting in dysphagia or symptoms resembling gastroesophageal reflux disease, symptoms that also are common in patients with a history of esophageal atresia. We present 2 patients with persistent dysphagia after repair of esophageal atresia that was caused by EoE. Although the exact etiology and pathogenesis of EoE remain unclear, it is now generally accepted that it is the result of a T-helper cell 2-type immune response with a crucial role for the eosinophil-specific chemotaxis factor eotaxin 3 and eosinophils. Because there are genetic similarities between esophageal atresia and EoE, we speculate that patients with esophageal atresia are at increased risk for developing EoE. PMID:22703825

Gorter, Ramon R; Heij, Hugo A; van der Voorn, J Patrick; Kneepkens, C M Frank

2012-06-01

286

Prognostic significance of differentially expressed miRNAs in esophageal cancer  

PubMed Central

Altered microRNA (miRNA) expression has been found to promote carcinogenesis, but little is known about the role of miRNAs in esophageal cancer. In this study, we selected 10 miRNAs and analyzed their expression in 10 esophageal cancer cell lines and 158 tissue specimens using Northern blotting and in situ hybridization, respectively. We found that Let-7g, miR-21, and miR-195p were expressed in all 10 cell lines, miR-9 and miR-20a were not expressed in any of the cell lines, and miR-16-2, miR-30e, miR-34a, miR-126, and miR-200a were expressed in some of the cell lines but not others. In addition, transient transfection of miR-34a inhibited c-Met and cyclin D1 expression and esophageal cancer cell proliferation, whereas miR-16-2 suppressed RAR-?2 expression and increased tumor cell proliferation. Furthermore, we found that miR-126 expression was associated with tumor cell de-differentiation and lymph node metastasis, miR-16-2 was associated with lymph node metastasis, and miR-195p was associated with higher pathologic disease stages in patients with esophageal adenocarcinoma. Kaplan-Meier analysis showed that miR-16-2 expression and miR-30e expression were associated with shorter overall and disease-free survival in all esophageal cancer patients. In addition, miR-16-2, miR-30e, and miR-200a expression were associated with shorter overall and disease-free survival in esophageal adenocarcinoma patients; however, miR-16-2, miR-30e, and miR-200a expression was not associated with overall or disease-free survival in squamous cell carcinoma patients. Our data indicate that further evaluation of miR-30e and miR-16-2 as prognostic biomarkers is warranted in patients with esophageal adenocarcinoma. In addition, the role of miR-34a in esophageal cancer also warrants further study.

Hu, Yuxin; Correa, Arlene M.; Hoque, Ashraful; Guan, Baoxiang; Ye, Fei; Huang, Jie; Swisher, Stephen G.; Wu, Tsung Teh; Ajani, Jaffer A.; Xu, Xiao-chun

2010-01-01

287

Effect of Multidisciplinary Treatment with High Dose Rate Intraluminal Brachytherapy on Survival in Patients with Unresectable Esophageal Cancer  

Microsoft Academic Search

Background: Since carcinoma of the esophagus is usually diagnosed at an advanced stage, many cases of esophageal cancer are beyond possible radical resection and only palliative treatment can be performed in such cases. Therefore, a great deal of discussion has taken place concerning indications for treatment modality, and various procedures have been performed to palliate such patients. The prognosis for

Masato Iwasa; Yoshinobu Ohmori; Yoshie Iwasa; Akira Yamamoto; Atsushi Inoue; Hironori Maeda; Motohiko Kume; Shohei Ogoshi; Akihito Nishioka; Yasuhiro Ogawa; Shoji Yoshida

1998-01-01

288

Genes Associated with Food Allergy and Eosinophilic Esophagitis.  

National Technical Information Service (NTIS)

The ingestion of food antigens plays an essential role in the development of eosinophilic esophagitis (EE) as total removal of dietary antigens by using an amino acid based oral formula improves clinical symptoms and esophageal histology in 98% of patient...

D. Broide

2011-01-01

289

GERD, Barrett's Esophagus and the Risk for Esophageal Cancer  

MedlinePLUS

GERD, Barrett's Esophagus and the Risk for Esophageal Cancer Am I at Risk for Esophageal Cancer? There ... commonly in Caucasians as well as people with gastroesophageal reflux disease (GERD). This cancer is increasing in frequency. ...

290

Endoscopic Mucosal Resection in the Management of Esophageal Neoplasia: Current Status and Future Directions  

PubMed Central

Endoscopic mucosal resection has expanded the role of the gastroenterologist in the management of esophageal neoplasia from screening and diagnosis to staging and endoscopic treatment. Its rise to prominence is a reflection of the long identified need to obtain histological information regarding depth of invasion and neoplastic margins during therapy that previously could not be achieved with ablative techniques. The resultant improvement in diagnosis and staging has allowed for better selection of patients for endoscopic therapy who may be spared invasive surgery. The clinical indications, endoscopic techniques, outcomes and complications in the management of esophageal neoplasia are reviewed in this manuscript. Training requirements to achieve proficiency in EMR as well as potential quality measures to assess competence are also proposed in this review.

Namasivayam, Vikneswaran; Wang, Kenneth K.; Prasad, Ganapathy A

2010-01-01

291

[ESOPHAGEAL STENOSIS IN CHILDREN: MEDICAL TREATMENT EXPERIENCE  

PubMed

We present a retrospective evaluation of our experience in the period that goes from January 1992 to December 1998, clinical records of 58 patients ages from 2 months old to 15 years, male and female, who were treated at the GI service of Instituto de Salud del Ni o, were reviewed. All of them had esophageal stenosis and were included in the Esophageal Dilatation Program with Savary-Gilliard bougies. The causes of Esophageal Stenosis in the study were: Caustic agents 37.9%, gastro esophageal reflux (GER) 20.7%, surgery sequela 19.0%, related to esophageal esclerotherapy 12.1%, foreign body itself or maneuvers to retrieve them 8.6%, stomach adenocarcinoma invading the esophagus. Patients were classified in three groups: Group 1: stenosis due to caustic agents Group 2: stenosis due to GER Group 3: The remaining causes mentioned above., In each the following was calculated: the arithmetical media, the range of dilatations sessions and the total number of them. The higher figures took place in group 1. So we conclude that the number of sessions is directly related with the cause of the stenosis, requiring more number of dilatations to get a better response. Finally the response to treatment is evaluated considering a good response in 72.4%. A mild response in 15.5% and therapeutic failure in 12.1% of patients. The rate of complications was 10.3 per patient and 1.1 in relation to the total number of dilatation sessions. The main complications were: gastric perforation, duodenal perforation, pneumomediastinum, esophago-tracheal fistulae andi pseudodiverticulum formation, with resolution as seen in posterior controls. These complications occured after the proceeding took place. The treatment was installed according to each case. The patients with duodenal perforation died. We conclude that esophageal dilatations in infants with esophageal stenosis, of different ethiology, are secure and efficient. PMID:12181577

Alarcón, Anibal; Talavera, Godofredo; Gonzales, Jóse; Rivera, Juan

292

Conditions for the induction of long-term potentiation in layer II/III horizontal connections of the rat motor cortex.  

PubMed

1. The present studies investigated conditions for the induction of long-term potentiation (LTP) in the local horizontal pathways of layers II/III in the primary motor cortex (MI) of the adult rat. Field potential and intracellular recordings demonstrated synaptic interactions across the superficial layers within MI that could be enhanced transiently by focal application of the gamma-aminobuturic acid-A receptor antagonist bicuculline methiodide (Bic) at the recording site. 2. Field potentials evoked in the superficial MI horizontal pathways increased in amplitude after tetanizing, theta burst stimulation (TBS), but only when Bic was applied transiently at the recording site immediately before TBS. In the absence of Bic, TBS failed to produce long-lasting increases in horizontally evoked field responses. By contrast, TBS delivery during focal Bic application increased field potential amplitudes by 25-35% when measured 25-30 min after stimulation. The amount of potentiation was greater when two converging horizontal inputs were stimulated together but was not increased with higher intensity stimulation. Persistent effects of Bic application alone were evident. However, these effects were small unless Bic application continued until evoked field potential amplitude increase exceeded 200% of baseline. 3. The synaptic nature of field potential increases were confirmed using intracellular recordings of layer II/III neurons located near field potential electrodes. 4. LTP also could be induced without Bic application by cotetanization of vertical pathways simultaneously with horizontal activation. Vertical conditioning alone at 2 Hz, which affects inhibitory efficacy, was shown to transiently relieve depression of successive responses that ordinarily occurs during a burst of three horizontal stimuli. These results suggest that LTP of horizontal pathways may be regulated by spatiotemporal interactions between horizontal and vertical pathways. 5. Horizontal LTP was blocked reversibly by bath application of the N-methyl-D-aspartate (NMDA) antagonist 2-amino-5-phosphonovaleric acid, thereby implicating NMDA-receptor activation in LTP induction for these pathways. 6. The results confirm and extend our previous finding that the potential for activity-dependent modification of synaptic connections exists within the intrinsic horizontal connections of the superficial cortical layers. Synaptic modification across horizontally connected neurons appears to be regulated both by the arrangement of intrinsic circuitry and by the availability of mechanisms for modification at individual synapses. The properties of horizontal connections indicate that they form a spatial substrate and provide an activity-dependent mechanism for plasticity of adult cortical representations. PMID:8734579

Hess, G; Aizenman, C D; Donoghue, J P

1996-05-01

293

Concomitant herpetic and eosinophilic esophagitis--a causality dilemma.  

PubMed

Eosinophilic and herpetic esophagitis are listed as independent causes of dysphagia, especially in young adult males. However, herpetic esophagitis rarely affects immunocompetent individuals. We report the case of a young, not immunocompromised patient, admitted because of severe dysphagia secondary to herpes simplex virus esophagitis. After complete resolution, an endoscopic and histologic reevaluation established the diagnosis of eosinophilic esophagitis. The potential association between the two conditions is discussed. PMID:23082710

Monsanto, P; Almeida, N; Cipriano, M A; Gouveia, H; Sofia, C

2012-09-01

294

Broken Esophageal Stent Successfully Treated by Interventional Radiology Technique  

SciTech Connect

Esophageal stent fractures occur quite rarely. A 61-year-old male patient was previously treated for rupture of benign stenosis, occurring after dilatation, by implanting an esophageal stent. However, a year after implantation, the patient suffered from dysphagia caused by the broken esophageal stent. He was treated with the interventional radiology technique, whereby a second implantation of the esophageal stent was carried out quite successfully.

Zelenak, Kamil, E-mail: zelenak@mfn.s [University Hospital, Department of Radiology (Slovakia); Mistuna, Dusan; Lucan, Jaroslav [University Hospital, Department of Surgery (Slovakia); Polacek, Hubert [University Hospital, Department of Radiology (Slovakia)

2010-06-15

295

Circulating microRNAs: Novel biomarkers for esophageal cancer  

PubMed Central

Esophageal carcinogenesis is a multi-stage process, involving a variety of changes in gene expression and physiological structure change. MicroRNAs (miRNAs) are a class of small non-coding endogenous RNA molecules. Recent innovation in miRNAs profiling technology have shed new light on the pathology of esophageal carcinoma (EC), and also heralded great potential for exploring novel biomarkers for both EC diagnosis and treatment. Frequent dysregulation of miRNA in malignancy highlights the study of molecular factors upstream of gene expression following the extensive investigation on elucidating the important role of miRNA in carcinogenesis. We herein present a thorough review of the role of miRNAs in EC, addressing miRNA functions, their putative role as oncogenes or tumor suppressors and their potential target genes. The recent progresses in discovering the quantifiable circulating cancer-associated miRNAs indicate the potential clinical use of miRNAs as novel minimally invasive biomarkers for EC and other cancers. We also discuss the potential role of miRNAs in detection, screening and surveillance of EC as miRNAs can be a potential target in personalized treatment of EC.

Zhou, Sheng-Li; Wang, Li-Dong

2010-01-01

296

Dosimetric consequences of breath-hold respiration in conformal radiotherapy of esophageal cancer  

Microsoft Academic Search

The objective of this paper is to study the dosimetric impact of respiratory gated radiotherapy in locally advanced esophageal carcinomaand to define the optimal respiratory phase for this treatment.The study included 8 consecutive patients with squamous-cell carcinoma (SCC) or histologically proved adenocarcinoma, for both at least T3–T4 NX or TX N1 M0 stage. Informed consent was obtained before beginning the

J. L. Dumas; A. Noël; D. Wolf; J. F. Bosset; P. Aletti

2006-01-01

297

Does empiric esophageal dilation benefit dysphagia when endoscopy is normal?  

Microsoft Academic Search

Some patients referred for esophagogastroduodenoscopy (EGD) to evaluate symptoms of dysphagia have normal endoscopies. How best to manage these patients is unclear. We reviewed our experience with empiric esophageal dilation in this setting. Over a five-year period, 40 consecutive patients with esophageal dysphagia and normal EGD underwent empiric esophageal dilation at the time of their endoscopy. Postdilation follow-up was available

John B. Marshall; Tabassum A. Chowdhury

1996-01-01

298

Prevention by Rebamipide of Acute Reflux Esophagitis in Rats  

Microsoft Academic Search

Proinflammatory factors, including neutrophil-derived oxygen free radicals and inflammatory cytokines, have recently been implicated in the pathogenesis of reflux esophagitis. Rebamipide has been widely used as an anti-ulcer agent. The aim of the present study was to assess the protective effect of rebamipide against acute reflux esophagitis in rats. Esophagitis was induced in rats by ligation at the limiting ridge

Kazuhiro Katada; Norimasa Yoshida; Yutaka Isozaki; Naoya Tomatsuri; Hiroshi Ichikawa; Yuji Naito; Takeshi Okanoue; Toshikazu Yoshikawa

2005-01-01

299

Genetic players in esophageal atresia and tracheoesophageal fistula  

Microsoft Academic Search

Esophageal atresia is a common and serious developmental anomaly, of which the causes remain largely unknown. Studies in vertebrate models indicate the importance of the sonic hedgehog pathway in esophageal atresia, but its relevance to the human condition remains to be defined. Now, three genes have been identified that cause syndromic forms of esophageal atresia when mutated. NMYC and SOX2

Han G Brunner; Hans van Bokhoven

2005-01-01

300

Endoscopic polypectomy: A promising therapeutic choice for esophageal carcinosarcoma  

Microsoft Academic Search

Esophageal carcinosarcoma is a rare malignant tumor composing of both carcinomatous and sarcomatous elements. Endoscopic therapy is less invasive and may represent an alternative to esophagectomy for superficial esophageal carcinosarcoma. Here, we report a 61-year-old male who was diagnosed as esophageal carcinosarcoma and underwent endoscopic polypectomy with well tolerance and favorable prognosis. We also present a brief review of the

Feng Ji; Yue-Mei Xu; Cheng-Fu Xu

2009-01-01

301

Chronic esophageal foreign bodies in pediatric patients: a retrospective review  

Microsoft Academic Search

Objective: Chronic esophageal foreign bodies (CEFB) are associated with a high incidence of morbidity and mortality in adults. However, the presentation, management and outcome of chronic esophageal foreign bodies in children are not well described. Methods: We performed a retrospective chart review of children with chronic esophageal foreign bodies admitted to the Children’s Hospital Medical Center, Cincinnati, OH, between May

Robert Sean Miller; J. Paul Willging; Michael J. Rutter; Korpong Rookkapan

2004-01-01

302

Pharmacological management of esophageal food bolus impaction.  

PubMed

Background. Soft esophageal bolus impaction is an emergency that requires skilled endoscopic removal if persistent obstructive symptoms do not resolve spontaneously after careful observation. Expedited care of these patients is crucial to avoid respiratory and mechanical complications. Other possible options for management include medical agents used to manage it prior to performing endoscopy if access to endoscopy was not available or declined by the patient. Aim. To review the available pharmacological and other nonmedicinal options and their mechanism of relief for soft esophageal impaction. Method. Pubmed, Medline and Ovid were used for search of MESH terms pertinent including "foreign body, esophageal, esophageal bolus and medical" for pharmacological and non medicinial agents used for management of esophageal soft bolus impaction as well as manual review of the cross-references. Results. Several agents were identified including Buscopan, Glucagon, nitrates, calcium channel blockers, and papaveretum. Non medicinal agents are water, effervescent agents, and papain. No evidence was found to suggest preference or effectiveness of use of a certain pharmacological agent compared to others. Buscopan, Glucagon, benzodiazepines, and nitrates were studied extensively and may be used in selected patients with caution. Use of papain is obsolete in management of soft bolus impaction. PMID:23738071

Khayyat, Yasir Mohammed

2013-05-13

303

Airway and Esophageal Stenting in Patients with Advanced Esophageal Cancer and Pulmonary Involvement  

PubMed Central

Background Most inoperable patients with esophageal-advanced cancer (EGC) have a poor prognosis. Esophageal stenting, as part of a palliative therapy management has dramatically improved the quality of live of EGC patients. Airway stenting is generally proposed in case of esophageal stent complication, with a high failure rate. The study was conducted to assess the efficacy and safety of scheduled and non-scheduled airway stenting in case of indicated esophageal stenting for EGC. Methods and Findings The study is an observational study conducted in pulmonary and gastroenterology endoscopy units. Consecutive patients with EGC were referred to endoscopy units. We analyzed the outcome of airway stenting in patients with esophageal stent indication admitted in emergency or with a scheduled intervention. Forty-four patients (58±\\?8 years of age) with esophageal stenting indication were investigated. Seven patients (group 1) were admitted in emergency due to esophageal stent complication in the airway (4 fistulas, 3 cases with malignant infiltration and compression). Airway stenting failed for 5 patients. Thirty-seven remaining patients had a scheduled stenting procedure (group 2): stent was inserted for 13 patients with tracheal or bronchial malignant infiltration, 12 patients with fistulas, and 12 patients with airway extrinsic compression (preventive indication). Stenting the airway was well tolerated. Life-threatening complications were related to group 1. Overall mean survival was 26+/?10 weeks and was significantly shorter in group 1 (6+/?7.6 weeks) than in group 2 (28+/?11 weeks), p<0.001). Scheduled double stenting significantly improved symptoms (95% at day 7) with a low complication rate (13%), and achieved a specific cancer treatment (84%) in most cases. Conclusion Stenting the airway should always be considered in case of esophageal stent indication. A multidisciplinary approach with initial airway evaluation improved prognosis and decreased airways complications related to esophageal stent. Emergency procedures were rarely efficient in our experience.

Paganin, Fabrice; Schouler, Laurent; Cuissard, Laurent; Noel, Jean Baptiste; Becquart, Jean-Philippe; Besnard, Mathieu; Verdier, Laurent; Rousseau, Denis; Arvin-Berod, Claude; Bourdin, Arnaud

2008-01-01

304

Comprehensive study of DNA binding on Iron(II,III) oxide nanoparticles with a positively charged polyamine three-dimensional coating.  

PubMed

Iron (II,III) oxide Fe3O4 nanoparticles (25 and 50 nm NPs) are grafted with amine groups through silanization in order to generate a positively charged coating for binding negatively charged species including DNA molecules. The spatial nature of the coating changes from a 2-D-functionalized surface (monoamines) through a layer of amine oligomers (diethylenetriamine or DETA, about 1 nm in length) to a 3-D layer of polyamine (polyethyleneimine or PEI, thickness ?3.5 nm). These Fe3O4-PEI NPs were prepared by binding short-chain PEI polymers to the iodopropyl groups grafted on the NP surface. In this work, the surface charge density, or zeta potential, of the nanoparticles is found not to be the only factor influencing the DNA binding capacity, which also seems not to be affected by their buffering capacity profile in the range of pH 4-10. This study also allows the investigation of this 3-D effect on the surface of a nanoparticle as opposed to conventional 2-D amine functionalization. The flexibility of the PEI coating, which consists of only 1, 2, and 3° amines, on the nanoparticle surface has a significant influence on the overall DNA binding capacity and the binding efficiency (or N/P ratio). These polyamine-functionalized nanoparticles can be used in the purification of biomolecules and the delivery of drugs and large biomolecules. PMID:23941510

Yiu, Humphrey H P; Bouffier, Laurent; Boldrin, Paul; Long, James; Claridge, John B; Rosseinsky, Matthew J

2013-08-27

305

Chemical Equilibrium and Critical Phenomena: The Solubilities of Iron(III) Oxide and Cobalt(II,III) Oxide in Isobutyric Acid + Water Near the Consolute Point  

NASA Astrophysics Data System (ADS)

The solubilities of iron(III) oxide, formula Fe2O3, and cobalt(II,III) oxide, formula Co3O4, have been determined in the liquid mixture, isobutyric acid + water, along the critical isopleth at temperatures above the upper critical solution temperature near 299 K. When plotted in van’t Hoff form with ln s versus 1/ T, the measurements of solubility, s, lie on a straight line for values of the temperature, T, in kelvin, which are sufficiently in excess of the critical solution temperature, T c. The sign of the slope, (? ln s/?(1/ T)), indicates that in the case of both oxides, the dissolution reaction is endothermic. When the temperature is within 1K of T c, however, the slope departs from its constant value and appears to diverge toward negative infinity. The principle of critical-point universality predicts that a divergence in (? ln s/?(1/ T)) is to be expected for T near T c in those cases where the stoichiometry of the dissolution reaction involves both components of the solvent; moreover, the Gibbs-Helmholtz equation predicts that, if the heat of solution is endothermic, the sign of the divergence should be negative. Both of these predictions are confirmed by the solubilities of Fe2O3 and Co3O4 measured as a function of temperature along the critical isopleth of isobutyric acid + water.

Hu, Baichuan; Baird, James K.

2010-05-01

306

Synaptic and extrasynaptic origin of the excitation/inhibition imbalance in the hippocampus of synapsin I/II/III knockout mice.  

PubMed

Synapsins (Syn I, Syn II, and Syn III) are a family of synaptic vesicle phosphoproteins regulating synaptic transmission and plasticity. SYN1/2 genes have been identified as major epilepsy susceptibility genes in humans and synapsin I/II/III triple knockout (TKO) mice are epileptic. However, excitatory and inhibitory synaptic transmission and short-term plasticity have never been analyzed in intact neuronal circuits of TKO mice. To clarify the generation and expression of the epileptic phenotype, we performed patch-clamp recordings in the CA1 region of acute hippocampal slices from 1-month-old presymptomatic and 6-month-old epileptic TKO mice and age-matched controls. We found a strong imbalance between basal glutamatergic and ?-aminobutyric acid (GABA)ergic transmission with increased evoked excitatory postsynaptic current and impaired evoked inhibitory postsynaptic current amplitude. This imbalance was accompanied by a parallel derangement of short-term plasticity paradigms, with enhanced facilitation of glutamatergic transmission in the presymptomatic phase and milder depression of inhibitory synapses in the symptomatic phase. Interestingly, a lower tonic GABA(A) current due to the impaired GABA release is responsible for the more depolarized resting potential found in TKO CA1 neurons, which makes them more susceptible to fire. All these changes preceded the appearance of epilepsy, indicating that the distinct changes in excitatory and inhibitory transmission due to the absence of Syns initiate the epileptogenic process. PMID:22368083

Farisello, Pasqualina; Boido, Davide; Nieus, Thierry; Medrihan, Lucian; Cesca, Fabrizia; Valtorta, Flavia; Baldelli, Pietro; Benfenati, Fabio

2012-02-24

307

Combining non-destructive nuclear techniques to study Roman leaded copper coins from Ilipa (II-I centuries B.C.)  

NASA Astrophysics Data System (ADS)

A set of 32 bronze coins (II-I centuries B.C.) from the Roman city of Ilipa Magna (present-day Alcalá del Río, Seville) have been analyzed by means of non-destructive techniques. These coins are classified in different series according to their numismatic characteristics. They are very interesting from the archaeological point of view because a freshwater fish is depicted on the obverse (unusual in Mediterranean Cultures) and a spike on the reverse (also unusual but frequent in the South of the Iberian Peninsula). A comparative study has been made by PIXE (Proton Induced X-ray Emission) and XRF (X-ray Fluorescence) both corrected by GRT (Gamma Ray Transmission) in order to avoid the polishing of the coins. The results show that after the correction with GRT both independent methods give compatible concentrations for all of the coins that can be assumed as the actual bulk compositions [1]. The average concentrations of the different series have been calculated and they could help to classify the series of coins chronologically.

Moreno-Suárez, A. I.; Gómez-Tubío, B.; Respaldiza, M. A.; Chaves, F.; Ortega-Feliu, I.; Ontalba-Salamanca, M. Á.; Ager, F. J.

2011-12-01

308

Integrated Fast Neutron Flux at the End of Phases I, II, III, and IV-1B of the MOX Zr-cladding Tube  

SciTech Connect

This report using the detailed ATR quarter core model calculated neutronic tallies, the MCWO-calculated Zr-cladding fast neutron fluence (E > 0.1 MeV and E > 1.0 MeV) distributions at the end of Phase-I, -II, -III, and -IV Irradiation are tabulated in Table 1, 2, 3, and 4. At the end of the Phase-I irradiation, the MCWO-calculated Zr-cladding fast neutron fluences of the removed MOX capsules 1 and 8 are 2.68 and 2.68 x 1020 n/cm2, respectively. At the end of Phase-II Irradiation are tabulated in Table 2. At the end of the Phase-II irradiation, the MCWO-calculated Zr-cladding fast neutron fluences of the removed MOX capsules 9 and 2 are 6.78 and 6.79 x 1020 n/cm2, respectively. At the end of the Phase-III irradiation, the MCWO-calculated Zr-cladding fast neutron fluences of the removed MOX capsules 10 and 3 are 9.82 and 9.70 x 1020 n/cm2, respectively. And, at the end of the Phase-IV part 1B irradiation, the MCWO-calculated Zr-cladding fast neutron fluences of the removed MOX capsules 4 and 13 are 1.41 and 1.39 x 1021 n/cm2, respectively.

Gray Chang

2004-03-01

309

In vivo methylmercury exposure induced long-lasting epileptiform activity in layer II/III neurons in cortical slices from the rat  

PubMed Central

Prenatal and postnatal methylmercury (MeHg) exposure has been shown to increase neuronal excitability and seizure susceptibility. To determine if early postnatal MeHg exposure causes a similar effect, we examined changes in field potentials in layer II/III neurons in cortical slices of rat following in vivo MeHg treatment. Rats received 0 (0.9% NaCl), 0.75 or 1.5 mg/kg/day MeHg subcutaneously for 15 or 30 days beginning on postnatal day 5, after which cortical slices were prepared for field potential recordings. In slices from rats treated with vehicle, single pulse stimulation of layer IV of cortical slices induced a typical field excitatory postsynaptic potential (fEPSP) with a single spike. This type of fEPSPs was also seen in slices from rats with 15 day treatment with 0.75 or 1.5 mg/kg/day MeHg. However, 30 day treatment with either MeHg dose resulted in fEPSPs with multiple spikes (epileptiform activity) in 40% of animals examined. This epileptiform activity remained observable in 50 – 60% animals in which MeHg exposure had been terminated for 30 days. However, slices from control animals still showed fEPSPs with single spike. Thus, these data suggest that postnatal MeHg exposure in vivo altered neuronal excitability and induced a long-lasting hyperexcitability in cortical neurons.

Dasari, Sameera; Yuan, Yukun

2010-01-01

310

Long-term evaluation of esophageal and pulmonary function in patients with repaired esophageal atresia and tracheoesophageal fistula  

Microsoft Academic Search

Patients who have undergone repair of esophageal atresia and tracehoesophageal fistula as infants have been noted to have residual esophageal dysmotility and pulmonary dysfunction during their childhood years. However, limited information is available about the long-term follow-up of these patients. In this study we performed esophageal and pulmonary function studies on 12 adults who had required surgical repair of these

Jeffrey A. Biller; Julian L. Allen; Samuel R. Schuster; S. T. Treves; Harland S. Winter

1987-01-01

311

Recent developments in esophageal adenocarcinoma.  

PubMed

Answer questions and earn CME/CNE Esophageal adenocarcinoma (EAC) is characterized by 6 striking features: increasing incidence, male predominance, lack of preventive measures, opportunities for early detection, demanding surgical therapy and care, and poor prognosis. Reasons for its rapidly increasing incidence include the rising prevalence of gastroesophageal reflux and obesity, combined with the decreasing prevalence of Helicobacter pylori infection. The strong male predominance remains unexplained, but hormonal influence might play an important role. Future prevention might include the treatment of reflux or obesity or chemoprevention with nonsteroidal antiinflammatory drugs or statins, but no evidence-based preventive measures are currently available. Likely future developments include endoscopic screening of better defined high-risk groups for EAC. Individuals with Barrett esophagus might benefit from surveillance, at least those with dysplasia, but screening and surveillance strategies need careful evaluation to be feasible and cost-effective. The surgery for EAC is more extensive than virtually any other standard procedure, and postoperative survival, health-related quality of life, and nutrition need to be improved (eg, by improved treatment, better decision-making, and more individually tailored follow-up). Promising clinical developments include increased survival after preoperative chemoradiotherapy, the potentially reduced impact on health-related quality of life after minimally invasive surgery, and the new endoscopic therapies for dysplastic Barrett esophagus or early EAC. The overall survival rates are improving slightly, but poor prognosis remains a challenge. CA Cancer J Clin 2013. © 2013 American Cancer Society. PMID:23584949

Lagergren, Jesper; Lagergren, Pernilla

2013-04-12

312

Recent developments in esophageal adenocarcinoma.  

PubMed

Answer questions and earn CME/CNE Esophageal adenocarcinoma (EAC) is characterized by 6 striking features: increasing incidence, male predominance, lack of preventive measures, opportunities for early detection, demanding surgical therapy and care, and poor prognosis. Reasons for its rapidly increasing incidence include the rising prevalence of gastroesophageal reflux and obesity, combined with the decreasing prevalence of Helicobacter pylori infection. The strong male predominance remains unexplained, but hormonal influence might play an important role. Future prevention might include the treatment of reflux or obesity or chemoprevention with nonsteroidal antiinflammatory drugs or statins, but no evidence-based preventive measures are currently available. Likely future developments include endoscopic screening of better defined high-risk groups for EAC. Individuals with Barrett esophagus might benefit from surveillance, at least those with dysplasia, but screening and surveillance strategies need careful evaluation to be feasible and cost-effective. The surgery for EAC is more extensive than virtually any other standard procedure, and postoperative survival, health-related quality of life, and nutrition need to be improved (eg, by improved treatment, better decision-making, and more individually tailored follow-up). Promising clinical developments include increased survival after preoperative chemoradiotherapy, the potentially reduced impact on health-related quality of life after minimally invasive surgery, and the new endoscopic therapies for dysplastic Barrett esophagus or early EAC. The overall survival rates are improving slightly, but poor prognosis remains a challenge. PMID:23818335

Lagergren, Jesper; Lagergren, Pernilla

313

[ESOPHAGEAL VARICES LIGATION WITH NATIVE TECHNOLOGY  

PubMed

With the goal to assess the efficacy of a simple set of endoscopic ligation of esophageal varices, we conducted a prospective study in the public Goyeneche Hospital, Arequipa, Per . Ten patients between 17 and 68 years old (mean 48 years)diagnosed with digestive hemorrhage due to grade III-IV esophageal varices caused by hepatic cirrhosis were subject to endoscopic ligation. We succesfully used this simple device without overtube, in a total of 34 sessions, with 3 to 6 bands (mean 4) per session in only one introduction of endoscopy without active vericeal hemorrhage. Endoscopic treatment was repeated at 1-to-2 week intervals until variceal eradication was achieved. Only one complication (p<0.001) in the third session due to esophageal distal estenosis that was resolved with dilatation. This procedure could be useful as practical alternative of easy access and lower cost as a therapeutic option to sclerotheraphy and less complications. PMID:12138386

Zevallos, José

314

Early esophageal carcinoma treated with intracavitary irradiation  

SciTech Connect

Five patients with early esophageal carcinoma were treated by 6-12 Gy of intracavitary irradiation following 50-60 Gy of external irradiation as a boost therapy. Surgery was not performed in these cases. None of the patients had local recurrence after radiation therapy, as demonstrated by esophagography and endoscopy. Three patients have been alive for 1-3 years 10 months. Esophageal ulceration induced by intracavitary irradiation has occurred in three of the five patients; however, intracavitary irradiation is still a beneficial treatment because of its efficacy in controlling local lesions and because radiation ulceration can eventually be cured. Intracavitary irradiation is recommended to follow external irradiation as a boost therapy for the treatment of early esophageal carcinoma.

Hishikawa, Y.; Tanaka, S.; Miura, T.

1985-08-01

315

MicroRNA involvement in esophageal carcinogenesis  

PubMed Central

MicroRNAs (miRs) have recently emerged as a novel class of gene expression regulators. The number of studies documenting an altered miR expression pattern in cancer continues to expand rapidly. Critical information is continuously gained regarding how aberrantly expressed miRs contribute to carcinogenesis. Current studies provide evidence that analyses of miR expression patterns have potential clinical applications toward developing tumor biomarkers to identify the presence and dissemination of esophageal cancer, as well as to assess tumor chemo- or radiosensitivity. The incidence of esophageal cancer is on the rise, and this disease continues to portend a poor prognosis. The current review addresses ways in which altered miR expression contributes to esophageal carcinogenesis, along with how recent discoveries may be applied clinically.

David, Stefan; Meltzer, Stephen J.

2011-01-01

316

Cdx1 and c-Myc Foster the Initiation of Transdifferentiation of the Normal Esophageal Squamous Epithelium toward Barrett's Esophagus  

PubMed Central

Background Barrett's esophagus is a premalignant condition whereby the normal stratified squamous esophageal epithelium undergoes a transdifferentiation program resulting in a simple columnar epithelium reminiscent of the small intestine. These changes are typically associated with the stratified squamous epithelium chronically exposed to acid and bile salts as a result of gastroesophageal reflux disease (GERD). Despite this well-defined epidemiologic association between acid reflux and Barrett's esophagus, the genetic changes that induce this transdifferentiation process in esophageal keratinocytes have remained undefined. Methodology/Principal Findings To begin to identify the genetic changes responsible for transdifferentiaiton in Barrett's esophagus, we performed a microarray analysis of normal esophageal, Barrett's esophagus and small intestinal biopsy specimens to identify candidate signaling pathways and transcription factors that may be involved. Through this screen we identified the Cdx1 homeodomain transcription factor and the c-myc pathway as possible candidates. Cdx1 and c-myc were then tested for their ability to induce transdifferentiation in immortalized human esophageal keratinocytes using organotypic culturing methods. Analyses of these cultures reveal that c-myc and cdx1 cooperate to induce mucin production and changes in keratin expression that are observed in the epithelium of Barrett's esophagus. Conclusions/Significance These data demonstrate the ability of Cdx1 and c-myc to initiate the earliest stages of transdifferentiation of esophageal keratinocytes toward a cell fate characteristic of Barrett's esophagus.

Stairs, Douglas B.; Nakagawa, Hiroshi; Klein-Szanto, Andres; Mitchell, Shukriyyah D.; Silberg, Debra G.; Tobias, John W.; Lynch, John P.; Rustgi, Anil K.

2008-01-01

317

Avoiding complications in esophageal cancer surgery.  

PubMed

Modern handling of esophageal cancer patients is based on a multidisciplinary concept, but surgery remains the primary curative treatment modality. Improvements in the perioperative care have reduced the overall morbidity and mortality, but 2-7% of the patients may still die within 30 days as a direct consequence of complications related to the esophagectomy procedure. Primarily based on results from randomized studies published after 2000 this review describes some of the factors that may contribute to the development of postoperative complications following esophageal cancer surgery as well as studies intended to finding ways of reducing the complication rate. PMID:24019042

Bau Mortensen, M

2013-08-01

318

Elevated Maspin Expression Is Associated with Better Overall Survival in Esophageal Squamous Cell Carcinoma (ESCC)  

PubMed Central

Tumor suppressor maspin is a differentially regulated gene in the progression of many types of cancer. While the biological function of maspin in blocking tumor invasion and metastasis is consistent with the loss of maspin expression at the late stage of tumor progression, the differential expression and the biological significance of maspin in early stage of tumor progression appear to be complex and remain to be elucidated. In the current study, we examined the expression of maspin in 84 esophageal squamous cell carcinoma (ESCC) cases (stages I–III) and 55 non-tumor adjacent esophageal tissue specimens by immunohistochemical (IHC) staining. The correlation of maspin with clinicopathological parameters was analyzed. Compared to normal esophageal squamous tissue where 80% (47/55) of the cases expressed maspin at a low to moderate level, all ESCC specimens (100% (84/84)) were positive for maspin expression at a moderate to high level. ESCC with low or moderate maspin expression had significantly shorter postoperative survival rates compared to those that had high maspin expression (p<0.001). Since the correlation of maspin with ESCC histology and the correlation of maspin with ESCC prognosis seem to be at odds, we further investigated the biological function of maspin in ESCC using the established ESCC cell lines. The expression of maspin in five human esophageal squamous cancer cell lines (T12, E450, KYSE150, EC109, and KYSE510) was examined by the Western blot. ESCC cell line KYSE510 that did not express maspin and was stably transfected by maspin cDNA or an empty vector. The resulting transfected cells were characterized in vitro. Maspin expression significantly inhibited cell proliferation, motility and matrigel invasion. Taken together, our data suggest that the transient up-regulation of maspin in the early development of ESCC may be a defense mechanism against further transition towards more malignant phenotypes, ultimately slowing down ESCC tumor progression.

Wang, Yang; Sheng, Shijie; Zhang, Jianzhi; Dzinic, Sijana; Li, Shaolei; Fang, Fang; Wu, Nan; Zheng, Qingfeng; Yang, Yue

2013-01-01

319

Drug-induced esophageal injury with an occult vascular ring  

PubMed Central

Drug-induced esophageal injury is an under-recognized clinical problem, and is associated with antibiotic use in more than 50% of cases. The current report describes a teenage girl who presented with symptoms of pill-induced esophagitis following doxycycline use. Subsequent investigations identified a previously undiagnosed vascular ring. Although most patients who experience drug-induced esophageal injury have no underlying anatomical or functional disorder of the esophagus, the condition is more common in areas of esophageal narrowing. The present case illustrates the possibility of an occult esophageal obstruction representing a risk factor for pill esophagitis. The etiologies, mechanisms and management of drug-induced esophageal injury are reviewed, and aspects of vascular rings that are relevant to paediatricians are discussed.

Guttman, Orlee R; Zachos, Mary

2011-01-01

320

Epidermal growth factor receptor: an important target in esophageal cancer.  

PubMed

Introduction: Even after complete tumor removal by surgery, the clinical outcomes remain poor in patients with advanced esophageal cancer, justifying the need for new treatment options. Epidermal growth factor receptor (EGFR) is a molecular target for antibody-based therapy in various cancer types, and it may play important roles in the development of esophageal cancer. Areas covered: This review evaluates the expression, function, and mechanism of EGFR in esophageal cancer and analyzes its value for the prognosis and therapy of esophageal cancer. Future developments toward the clinical applications of EGFR to cancer treatment are also envisaged. Expert opinion: EGFR may function as an ideal therapeutic target for esophageal cancer. Further investigation of epidermal growth-factor-receptor-mediated pathways will push insight into the novel strategies of target therapy for esophageal cancer. More clinical trials should be performed to promote the success of therapeutic-clinical use of EGFR and its targets in esophageal cancer. PMID:23855932

Hong, Liu; Han, Yu; Brain, Lubi

2013-07-16

321

Roles of ZO-1 and Epidermal Growth Factor in Esophageal Epithelial Defense against Acid  

Microsoft Academic Search

Background: The tight junction plays a crucial role in structural esophageal epithelial defenses that maintain esophageal epithelial integrity. We examined the roles of ZO-1 and epidermal growth factor (EGF) in esophageal epithelial defense against acid using human esophageal epithelial cells. Methods: Human esophageal epithelial cells (TE-1) were incubated with acidified medium in the presence or absence of various doses of

Masatsugu Okuyama; Yasuhiro Fujiwara; Tetsuya Tanigawa; Kenji Watanabe; Masatsugu Shiba; Kazunari Tominaga; Toshio Watanabe; Nobuhide Oshitani; Kazuhide Higuchi; Tetsuo Arakawa

2007-01-01

322

Influence of Ionizing Radiation on Stromal-Epithelial Communication in Esophageal Carcinogenesis  

NASA Astrophysics Data System (ADS)

Esophageal cancer is the 6th leading cause of cancer death worldwide and is associated with a variety of risk factors including tobacco use, heavy alcohol consumption, human papilloma virus infection, and certain dietary factors such as trace mineral and vitamin deficiencies. A connection with ionizing radiation exposure is revealed by the high excess relative risk for esophageal squamous cell carcinoma observed in the survivors of the atomic bomb detonations in Japan. Esophageal carcinomas are also seen as secondary malignancies in patients who received radiotherapy for breast and thoracic cancers; additionally, patients with head/neck and oral squamous cell cancers are at increased risk for metachronous esophageal squamous cell cancers. This malignancy is rapidly fatal, mainly because it remains asymptomatic until late, advanced stages when the disease is rarely responsive to treatment. In normal epithelium, the stromal microenvironment is essential for the maintenance and modulation of cell growth and differentiation. Cross talk between the epithelial and stromal compartments can influence many aspects of malignant progression, including tumor cell proliferation, migration, invasion and recruitment of new blood vessels. To test the hypothesis that radiation exposure plays a role in esophageal carcinogenesis via non-targeted mechanisms involving stromal-epithelial cell communication, we are studying radiation effects on hTERT-immortalized human esophageal epithelial cells and genetic variants grown in co-culture with human esophageal stromal fibrob-lasts (Okawa et al., Genes Dev. 2007. 21: 2788-2803). We examined how irradiation of stromal fibroblasts affected epithelial migration and invasion, behaviors associated with cancer promotion and progression. These assays were conducted in modified Boyden chambers using conditioned media from irradiated fibroblasts. Our results using low LET gamma radiation showed a dose-dependent increase in migration of epithelial cells when exposed to conditioned media from irradiated vs. non-irradiated fibroblasts. We also observed enhanced invasion through a basement membrane matrix in similarly treated cells. Candidate factors that me-diate these effects were identified using antibody capture arrays, and their increased secretion in irradiated fibroblasts was confirmed using ELISAs. We are currently analyzing the effect of these individual factors on epithelial migration and invasion, as well as their influence on cell survival and DNA repair. Our current studies using high-LET radiation will elucidate radiation quality effects on these processes. These results should further our understanding of the mechanisms by which radiation impacts the tissue microenvironment and how it influences cancer development processes.

Huff, Janice; Patel, Zarana; Grugan, Katharine; Rustgi, Anil; Cucinotta, Francis A.

323

Health-related quality of life in WHO Class II–III obese men losing weight with very-low-energy diet and behaviour modification: a randomised clinical trial  

Microsoft Academic Search

OBJECTIVE: To study health-related quality of life responses to marked weight loss in WHO Class II–III (body mass index (BMI) ?35 kg\\/m2) obese men.DESIGN: An 8 month randomised clinical trial with a 4 month weight loss programme (10 weeks on a very-low-energy diet (VLED) and 17 behaviour modification visits) in the treatment group and no intervention in the control group.SUBJECTS:

J Kaukua; T Pekkarinen; T Sane; P Mustajoki

2002-01-01

324

Prevalence of Increased Esophageal Muscle Thickness in Patients With Esophageal Symptoms  

Microsoft Academic Search

BACKGROUND:Patients with achalasia, diffuse esophageal spasm (DES), and nutcracker esophagus have a thicker muscularis propria than normal subjects. The goal of our study was to determine the prevalence of increased muscle thickness in a group of unselected patients referred to the esophageal function laboratory for evaluation of the symptoms.METHODS:We studied 40 normal subjects and 94 consecutive patients. Manometry and ultrasound

Ibrahim Dogan; James L. Puckett; Bikram S. Padda; Ravinder K. Mittal

2007-01-01

325

Self-expanding esophageal metallic stents in the treatment of esophageal obstruction.  

PubMed

Esophageal obstruction from any cause is debilitating. In patients with malignant obstruction palliation to relieve pain and dysphagia is the primary goal. Conventional endoluminal prostheses allow variable palliation. Covered expandable metallic stents with an 18-mm lumen allow improved deglutition. From December 1994 through December 1998, 59 patients underwent placement of self-expanding silicone-covered esophageal stents for esophageal obstruction. There were 36 men and 23 women ranging in age from 41 to 94. All patients underwent esophageal dilation using a flexible gastroscope and Savary bougies. After dilation placement of the stent was performed under fluoroscopic control. Follow-up was complete in all patients. Technical success was achieved in all patients. There was one postoperative death (bronchopulmonary fistula), one migration of the stent requiring removal, and one recurrent obstruction. The remaining stents were well tolerated even in the cervical region (four patients). All patients returned to a diet of solid foods. We conclude that covered self-expanding esophageal metallic stents are technically simple and safe to insert and appear to provide durable excellent palliation of esophageal obstruction due to either benign or malignant conditions. PMID:11261624

Cordero, J A; Moores, D W

2000-10-01

326

Humoral response to catumaxomab correlates with clinical outcome: results of the pivotal phase II/III study in patients with malignant ascites.  

PubMed

The trifunctional antibody catumaxomab is a targeted immunotherapy for the intraperitoneal treatment of malignant ascites. In a Phase II/III trial in cancer patients (n = 258) with malignant ascites, catumaxomab showed a clear clinical benefit vs. paracentesis and had an acceptable safety profile. Human antimouse antibodies (HAMAs), which could be associated with beneficial humoral effects and prolonged survival, may develop against catumaxomab as it is a mouse/rat antibody. This post hoc analysis investigated whether there was a correlation between the detection of HAMAs 8 days after the fourth catumaxomab infusion and clinical outcome. HAMA-positive and HAMA-negative patients in the catumaxomab group and patients in the control group were analyzed separately for all three clinical outcome measures (puncture-free survival, time to next puncture and overall survival) and compared to each other. There was a strong correlation between humoral response and clinical outcome: patients who developed HAMAs after catumaxomab showed significant improvement in all three clinical outcome measures vs. HAMA-negative patients. In the overall population in HAMA-positive vs. HAMA-negative patients, median puncture-free survival was 64 vs. 27 days (p < 0.0001; HR 0.330), median time to next therapeutic puncture was 104 vs. 46 days (p = 0.0002; HR 0.307) and median overall survival was 129 vs. 64 days (p = 0.0003; HR 0.433). Similar differences between HAMA-positive and HAMA-negative patients were seen in the ovarian, nonovarian and gastric cancer subgroups. In conclusion, HAMA development may be a biomarker for catumaxomab response and patients who developed HAMAs sooner derived greater benefit from catumaxomab treatment. PMID:21702044

Ott, Marion G; Marmé, Frederik; Moldenhauer, Gerhard; Lindhofer, Horst; Hennig, Michael; Spannagl, Rolf; Essing, Mirko M; Linke, Rolf; Seimetz, Diane

2011-09-27

327

The trifunctional antibody catumaxomab for the treatment of malignant ascites due to epithelial cancer: Results of a prospective randomized phase II/III trial.  

PubMed

Malignant ascites is a common manifestation of advanced cancers, and treatment options are limited. The trifunctional antibody catumaxomab (anti-epithelial cell-adhesion molecule x anti-CD3) represents a targeted immunotherapy for the intraperitoneal (i.p.) treatment of malignant ascites secondary to epithelial cancers. In this phase II/III trial (EudraCT 2004-000723-15; NCT00836654), cancer patients (n = 258) with recurrent symptomatic malignant ascites resistant to conventional chemotherapy were randomized to paracentesis plus catumaxomab (catumaxomab) or paracentesis alone (control) and stratified by cancer type (129 ovarian and 129 nonovarian). Catumaxomab was administered as an i.p. infusion on Days 0, 3, 7 and 10 at doses of 10, 20, 50 and 150 mug, respectively. The primary efficacy endpoint was puncture-free survival. Secondary efficacy parameters included time to next paracentesis, ascites signs and symptoms and overall survival (OS). Puncture-free survival was significantly longer in the catumaxomab group (median 46 days) than the control group (median 11 days) (hazard ratio = 0.254: p < 0.0001) as was median time to next paracentesis (77 versus 13 days; p < 0.0001). In addition, catumaxomab patients had fewer signs and symptoms of ascites than control patients. OS showed a positive trend for the catumaxomab group and, in a prospectively planned analysis, was significantly prolonged in patients with gastric cancer (n = 66; 71 versus 44 days; p = 0.0313). Although adverse events associated with catumaxomab were frequent, they were manageable, generally reversible and mainly related to its immunologic mode of action. Catumaxomab showed a clear clinical benefit in patients with malignant ascites secondary to epithelial cancers, especially gastric cancer, with an acceptable safety profile. PMID:20473913

Heiss, Markus M; Murawa, Pawel; Koralewski, Piotr; Kutarska, Elzbieta; Kolesnik, Olena O; Ivanchenko, Vladimir V; Dudnichenko, Alexander S; Aleknaviciene, Birute; Razbadauskas, Arturas; Gore, Martin; Ganea-Motan, Elena; Ciuleanu, Tudor; Wimberger, Pauline; Schmittel, Alexander; Schmalfeldt, Barbara; Burges, Alexander; Bokemeyer, Carsten; Lindhofer, Horst; Lahr, Angelika; Parsons, Simon L

2010-11-01

328

The trifunctional antibody catumaxomab for the treatment of malignant ascites due to epithelial cancer: Results of a prospective randomized phase II/III trial  

PubMed Central

Malignant ascites is a common manifestation of advanced cancers, and treatment options are limited. The trifunctional antibody catumaxomab (anti-epithelial cell-adhesion molecule x anti-CD3) represents a targeted immunotherapy for the intraperitoneal (i.p.) treatment of malignant ascites secondary to epithelial cancers. In this phase II/III trial (EudraCT 2004-000723-15; NCT00836654), cancer patients (n = 258) with recurrent symptomatic malignant ascites resistant to conventional chemotherapy were randomized to paracentesis plus catumaxomab (catumaxomab) or paracentesis alone (control) and stratified by cancer type (129 ovarian and 129 nonovarian). Catumaxomab was administered as an i.p. infusion on Days 0, 3, 7 and 10 at doses of 10, 20, 50 and 150 ?g, respectively. The primary efficacy endpoint was puncture-free survival. Secondary efficacy parameters included time to next paracentesis, ascites signs and symptoms and overall survival (OS). Puncture-free survival was significantly longer in the catumaxomab group (median 46 days) than the control group (median 11 days) (hazard ratio = 0.254: p < 0.0001) as was median time to next paracentesis (77 versus 13 days; p < 0.0001). In addition, catumaxomab patients had fewer signs and symptoms of ascites than control patients. OS showed a positive trend for the catumaxomab group and, in a prospectively planned analysis, was significantly prolonged in patients with gastric cancer (n = 66; 71 versus 44 days; p = 0.0313). Although adverse events associated with catumaxomab were frequent, they were manageable, generally reversible and mainly related to its immunologic mode of action. Catumaxomab showed a clear clinical benefit in patients with malignant ascites secondary to epithelial cancers, especially gastric cancer, with an acceptable safety profile.

Heiss, Markus M; Murawa, Pawel; Koralewski, Piotr; Kutarska, Elzbieta; Kolesnik, Olena O; Ivanchenko, Vladimir V; Dudnichenko, Alexander S; Aleknaviciene, Birute; Razbadauskas, Arturas; Gore, Martin; Ganea-Motan, Elena; Ciuleanu, Tudor; Wimberger, Pauline; Schmittel, Alexander; Schmalfeldt, Barbara; Burges, Alexander; Bokemeyer, Carsten; Lindhofer, Horst; Lahr, Angelika; Parsons, Simon L

2010-01-01

329

Humoral response to catumaxomab correlates with clinical outcome: Results of the pivotal phase II/III study in patients with malignant ascites  

PubMed Central

The trifunctional antibody catumaxomab is a targeted immunotherapy for the intraperitoneal treatment of malignant ascites. In a Phase II/III trial in cancer patients (n = 258) with malignant ascites, catumaxomab showed a clear clinical benefit vs. paracentesis and had an acceptable safety profile. Human antimouse antibodies (HAMAs), which could be associated with beneficial humoral effects and prolonged survival, may develop against catumaxomab as it is a mouse/rat antibody. This post hoc analysis investigated whether there was a correlation between the detection of HAMAs 8 days after the fourth catumaxomab infusion and clinical outcome. HAMA-positive and HAMA-negative patients in the catumaxomab group and patients in the control group were analyzed separately for all three clinical outcome measures (puncture-free survival, time to next puncture and overall survival) and compared to each other. There was a strong correlation between humoral response and clinical outcome: patients who developed HAMAs after catumaxomab showed significant improvement in all three clinical outcome measures vs. HAMA-negative patients. In the overall population in HAMA-positive vs. HAMA-negative patients, median puncture-free survival was 64 vs. 27 days (p < 0.0001; HR 0.330), median time to next therapeutic puncture was 104 vs. 46 days (p = 0.0002; HR 0.307) and median overall survival was 129 vs. 64 days (p = 0.0003; HR 0.433). Similar differences between HAMA-positive and HAMA-negative patients were seen in the ovarian, nonovarian and gastric cancer subgroups. In conclusion, HAMA development may be a biomarker for catumaxomab response and patients who developed HAMAs sooner derived greater benefit from catumaxomab treatment.

Ott, Marion G; Marme, Frederik; Moldenhauer, Gerhard; Lindhofer, Horst; Hennig, Michael; Spannagl, Rolf; Essing, Mirko M; Linke, Rolf; Seimetz, Diane

2012-01-01

330

Slow magnetic relaxation and electron delocalization in an S = 9/2 iron(II?III) complex with two crystallographically inequivalent iron sites.  

PubMed

The magnetic, electronic, and Mo?ssbauer spectral properties of [Fe(2)L(?-OAc)(2)]ClO(4), 1, where L is the dianion of the tetraimino-diphenolate macrocyclic ligand, H(2)L, indicate that 1 is a class III mixed valence iron(II?III) complex with an electron that is fully delocalized between two crystallographically inequivalent iron sites to yield a [Fe(2)](V) cationic configuration with a S(t) = 9?2 ground state. Fits of the dc magnetic susceptibility between 2 and 300 K and of the isofield variable-temperature magnetization of 1 yield an isotropic magnetic exchange parameter, J, of -32(2) cm(-1) for an electron transfer parameter, B, of 950 cm(-1), a zero-field uniaxial D(9?2) parameter of -0.9(1) cm(-1), and g = 1.95(5). In agreement with the presence of uniaxial magnetic anisotropy, ac susceptibility measurements reveal that 1 is a single-molecule magnet at low temperature with a single molecule magnetic effective relaxation barrier, U(eff), of 9.8 cm(-1). At 5.25 K the Mo?ssbauer spectra of 1 exhibit two spectral components, assigned to the two crystallographically inequivalent iron sites with a static effective hyperfine field; as the temperature increases from 7 to 310 K, the spectra exhibit increasingly rapid relaxation of the hyperfine field on the iron-57 Larmor precession time of 5 × 10(-8) s. A fit of the temperature dependence of the average effective hyperfine field yields |D(9?2)| = 0.9 cm(-1). An Arrhenius plot of the logarithm of the relaxation frequency between 5 and 85 K yields a relaxation barrier of 17 cm(-1). PMID:21548699

Hazra, Susanta; Sasmal, Sujit; Fleck, Michel; Grandjean, Fernande; Sougrati, Moulay T; Ghosh, Meenakshi; Harris, T David; Bonville, Pierre; Long, Gary J; Mohanta, Sasankasekhar

2011-05-01

331

Case report Recurrent spontaneous esophageal rupture  

Microsoft Academic Search

Spontaneous esophageal rupture is an uncommon and poorly understood condition. Recurrent rupture is extremely rare, with only one previously reported case in the literature. Here, we present a case series of two patients who had recurrent ruptures, and discuss the principles underlying the management of such cases. Q 2005 Elsevier B.V. All rights reserved.

Omar A. Khan; Clifford W. Barlow; David F. Weeden; Khalid M. Amer

332

Design technology in portable digital esophageal stethoscope  

Microsoft Academic Search

Auscultation of heart sound and breathing sound in anesthesia is very important, because it can provide the information of patient's cardiorespiratory system. In operating room, anesthesiologists use esophageal stethoscope, which is a device to measure heart sound or respiratory sound by inserting a catheter into the esophagus close to heart. It is not only low cost and very simple to

Ji-Yun Shin; Young Cheol Kim; Seung Woon Lim; Eun Jong Cha; Tae Soo Lee

2011-01-01

333

Synchronous primary esophageal and gastric cancers.  

PubMed

The diagnosed multiple cancer cases have recently been increasing in number. The frequency of synchronous esophageal and gastric carcinomas is increasing due to development of more sophisticated invasive and non-invasive diagnostic tools and an increase in the number of elderly patients. Four cases of synchronous esophageal and gastric cancers were diagnosed in 2nd Department of Radiology, Medical University of Lublin and in Radiological Department of Hospital in Krosno between the 1996 and 2002. In all cases double-contrast barium examinations of upper gastrointestinal tract were performed. In all cases the two lesions were found, separated by normal mucous membrane. In two cases the irregular tumor masses were localized in the gastric cardia. In two patients coexistent lesions form the oval filling defect, with hazy appearance in the middle of the anterior esophageal wall. In three cases the results of contrast examinations were confirmed with CT. Endoscopy with taking the specimens for histopathological examination supplemented the radiological examination. The results of histopathological examinations confirmed the diagnosis. The possibility of multiple primary cancers should be kept in mind during the preoperative examination. In case of esophageal cancer with severe stricture, when endoscope cannot be passed through the esophagus, the stomach should be carefully examined in a barium meal study. PMID:16146021

Pas?awski, Marek; Z?omaniec, Janusz; Ruci?ska, Eulalia; Ko?ty?, Witold

2004-01-01

334

Bioadhesive Dosage Forms for Esophageal Drug Delivery  

Microsoft Academic Search

No Heading The esophagus as a site for drug delivery has been much overlooked in comparison to the remainder of the gastrointestinal tract. The low permeability and transient nature of the esophagus means that it is unsuitable for delivery of drugs for systemic action. However, esophageal disorders including fungal infection, cancers, motility dysfunction, and damage due to gastric reflux may

Hannah Batchelor

2005-01-01

335

A safe treatment option for esophageal bezoars  

PubMed Central

INTRODUCTION Bezoar in the esophagus is a rare condition and associated with structural or functional abnormalities of the esophagus. Endoscopy is the main tool for diagnosis and treatment for bezoar in the esophagus. PRESENTATION OF CASE Here we present a case where an endoscopic evacuation of an esophageal bezoar was unsuccessful. We treated the bezoar through a nasogastric tube using a cocktail composed of pancreatic enzymes dissolved in Coca-Cola. DISCUSSION Endoscopy is regarded as the mainstay for the diagnosis and treatment of esophageal bezoars. However, when this approach fails, other treatment options include dissolution therapy, and surgical exploration and removal of the bezoar. Surgical removal of an esophageal bezoar is associated with a high risk of morbidity and mortality. We advocate that dissolving therapy should be the first choice of treatment when endoscopic evacuation is not possible. CONCLUSION This is the first report describing a successful treatment of an esophageal bezoar with a cocktail of Coca-Cola and pancreatic enzymes. It is an effective, inexpensive, and worldwide available treatment and should be considered when endoscopic evacuation fails.

Yaqub, Sheraz; Shafique, Muhammad; Kjaestad, Erik; Thorsen, Yngve; Lie, Erik S.; Dahl, Vegard; Bakka, Njal; R?kke, Ola

2012-01-01

336

Congenital tracheoesophageal fistula without esophageal atresia  

Microsoft Academic Search

The authors report a series of eight cases of isolated tracheoesophageal fistula without esophageal atresia (or an H type fistula), treated in three pediatric ENT departments. This is a rare malformation whose diagnosis requires investigation for associated anomalies. The clinical signs are mainly respiratory but also digestive and the symptomatology can be severe. The diagnosis can be made with a

Erwan Genty; Pierre Attal; Richard Nicollas; Gilles Roger; Jean-Michel Triglia; Erea-Noël Garabedian; Serge Bobin

1999-01-01

337

Tracheal Trifurcation Associated With Esophageal Atresia  

PubMed Central

We report a newborn with esophageal atresia (EA) in whom right tracheal bronchus (TB) and a tracheal diverticulum were identified intra-operatively. The right TB was further confirmed on MRI scan performed post-operatively. Such a tracheal trifurcation associated with EA has not been reported hitherto from Indian subcontinent.

2010-01-01

338

Optical Imaging with a Cathepsin B Activated Probe for the Enhanced Detection of Esophageal Adenocarcinoma by Dual Channel Fluorescent Upper GI Endoscopy  

PubMed Central

Despite significant advances in diagnosis and treatment, the prognosis of esophageal adenocarcinoma remains poor highlighting the importance of early detection. Although white light (WL) upper endoscopy can be used for screening of the esophagus, it has limited sensitivity for early stage disease. Thus, development of new imaging technology to improve the diagnostic capabilities of upper GI endoscopy for early detection of esophageal adenocarcinoma is an important unmet need. The goal of this study was to develop a method for the detection of malignant lesions in the esophagus using WL upper endoscopy combined with near infrared (NIR) imaging with a protease activatable probe (Prosense750) selective for cathepsin B (CTSB). An orthotopic murine model for distal esophageal adenocarcinoma was generated through the implantation of OE-33 and OE-19 human esophageal adenocarcinoma lines in immunocompromised mice. The mice were imaged simultaneously for WL and NIR signal using a custom-built dual channel upper GI endoscope. The presence of tumor was confirmed by histology and target to background ratios (TBR) were compared for both WL and NIR imaging. NIR imaging with ProSense750 significantly improved upon the TBRs of esophageal tumor foci, with a TBR of 3.64±0.14 and 4.50±0.11 for the OE-33 and OE-19 tumors respectively, compared to 0.88±0.04 and 0.81±0.02 TBR for WL imaging. The combination of protease probes with novel imaging devices has the potential to improve esophageal tumor detection by fluorescently highlighting neoplastic regions.

Habibollahi, Peiman; Figueiredo, Jose-Luiz; Heidari, Pedram; Dulak, Austin M; Imamura, Yu; Bass, Adam J.; Ogino, Shuji; Chan, Andrew T; Mahmood, Umar

2012-01-01

339

A CRP genetic polymorphism associated with the tumoral expression of CRP in esophageal cancer.  

PubMed

C-reactive protein (CRP) produced locally within esophageal cancer is associated with the prognosis and the rate of recurrence. CRP genetic polymorphisms reportedly affect serum CRP concentrations; however, there are no reports of an association between genetic polymorphisms and tumoral CRP expression. This study enrolled 73 Japanese patients classified with Stage IIA-IV thoracic esophageal squamous cell cancer, and also investigated their CRP genetic polymorphisms using DNA extracted from their peripheral blood. The study then assessed the association between CRP genetic polymorphisms and tumoral CRP expression. The results revealed a significant association between the CRP 1846C>T genetic polymorphism and tumoral CRP expression. This finding suggests that tumoral CRP production controlled by CRP genetics significantly influences tumor behavior. PMID:22911253

Motoyama, Satoru; Nakatsu, Toshinobu; Miura, Masatomo; Hinai, Yudai; Minamiya, Yoshihiro; Ogawa, Jun-ichi

2012-08-22

340

MicroRNA-34b has an oncogenic role in esophageal squamous cell carcinoma  

PubMed Central

Esophageal squamous cell carcinoma (ESCC) is a common malignancy and one of the more difficult diseases to diagnose in Japan due to its poor prognosis. MicroRNAs are small non-coding RNAs of 21–23 nucleotides that regulate gene expression. MicroRNA-34b (miR-34b) has been reported to be overexpressed in various types of cancer. However, its role in ESCC has yet to be extensively studied. The present study investigated the expression of miR-34b in 88 ESCC patients. The miR-34b expression in ESCC was significantly higher than that in the corresponding normal esophageal mucosa. It was more highly expressed in tumors with more advanced stages. However, its expression did not correlate with the p53 status. Transfection of anti-miR-34b to the ESCC cells suppressed cell growth in vitro. These results suggest an oncogenic role of miR in ESCC.

HARATA, KOSHIRO; ISHIGURO, HIDEYUKI; KUWABARA, YOSHIYUKI; KIMURA, MASAHIRO; MITSUI, AKIRA; OGAWA, RYO; KATADA, TAKEYASU; TANAKA, TATSUYA; SHIOZAKI, MIDORI; FUJII, YOSHITAKA

2010-01-01

341

Does surgery correct esophageal motor dysfunction in gastroesophageal reflux  

SciTech Connect

The high incidence of dysphagia in patients with symptomatic gastroesophageal reflux (GER) but no evidence of peptic stricture suggests esophageal motor dysfunction. Conventional methods for detecting dysfunction (radiologic and manometric examinations) often fail to detect abnormality in these patients. Radionuclide transit (RT), a new method for detecting esophageal motor dysfunction, was used to prospectively assess function in 29 patients with symptomatic GER uncomplicated by stricture before and three months after antireflux surgery (HILL). The preoperative incidence of dysphagia and esophageal dysfunction was 73% and 52%, respectively. During operation (Hill repair), intraoperative measurement of the lower esophageal sphincter pressure was performed and the LESP raised to levels between 45 and 55 mmHg. The preoperative lower esophageal sphincter pressure was raised from a mean of 8.6 mmHg, to mean of 18.5 mmHg after operation. No patient has free reflux after operation. Postoperative studies on 20 patients demonstrated persistence of all preoperative esophageal dysfunction despite loss of dysphagia. RT has demonstrated a disorder of esophageal motor function in 52% of patients with symptomatic GER that may be responsible for impaired esophageal clearance. This abnormality is not contraindication to surgery. The results indicate that construction of an effective barrier to reflex corrects symptoms of reflux, even in the presence of impaired esophageal transit. Radionuclide transit is a safe noninvasive test for assessment of esophageal function.

Russell, C.O.; Pope, C.E.; Gannan, R.M.; Allen, F.D.; Velasco, N.; Hill, L.D.

1981-09-01

342

Non-invasive Predictors of Esophageal Varices  

PubMed Central

Background/Aim: Current guidelines recommend screening cirrhotic patients with an endoscopy to detect esophageal varices and to institute prophylactic measures in patients with large esophageal varices. In this study, we aimed at identifying non-endoscopic parameters that could predict the presence and grades of esophageal varices. Patients and Methods: In a prospective study, 229 newly diagnosed patients with liver cirrhosis, without a history of variceal bleeding, were included. Demographic, clinical, biochemical and ultrasonographic parameters were recorded. Esophageal varices were classified as small and large, at endoscopy. Univariate analysis and multivariate logistic regression analysis were done to identify independent predictors for the presence and grades of varices. Results: Of the 229 patients (141 males; median age 42 years; range 17-73 years) with liver cirrhosis, 97 (42.3%) had small and 81 (35.4%) had large varices. On multivariate analysis, low platelet count (Odd’s Ratio [OR], 4.3; 95% confidence interval [CI], 1.2-14.9), Child Pugh class B/C (OR, 3.3; 95% CI, 1.8-6.3), spleen diameter (OR, 4.3; 95% CI, 1.6-11.9) and portal vein diameter (OR, 2.4; 95% CI, 1.1-5.3) were independent predictors for the presence of varices. Likewise, for the presence of large esophageal varices, low platelet count (OR, 2.7; 95% CI, 1.4-5.2), Child Pugh class B/C (OR, 3.8; 95% CI, 2.3-6.5) and spleen diameter (OR, 3.1; 95% CI, 1.6-6.0) were the independent risk factors. Conclusion: The presence and higher grades of varices can be predicted by a low platelet count, Child-Pugh class B/C and spleen diameter. These may be considered as non-endoscopic predictors for the diagnosis and management of large grade varices.

Cherian, Jijo V.; Deepak, Nandan; Ponnusamy, Rajesh Prabhu; Somasundaram, Aravindh; Jayanthi, V.

2011-01-01

343

Effect of Atilmotin, a Motilin Receptor Agonist, on Esophageal, Lower Esophageal Sphincter, and Gastric Pressures  

PubMed Central

Background Motilin, an endogenous gastrointestinal (GI) hormone, increases upper gastrointestinal tract motility and is associated with phase III of the gastric migrating motor complex. The motilin receptor agonist, atilmotin, at doses of 6, 30 or 60 µg intravenously (IV), increases the early phase of gastric emptying. Prior studies at higher doses of 100–450 µg IV demonstrated that some subjects developed noncardiac chest pain. Aims The aim of this study is to determine the effects of atilmotin on esophageal, lower esophageal sphincter (LES), and gastric contractility and the development of esophageal-related symptoms. Methods Ten healthy volunteers underwent esophageal manometry to study the effects of atilmotin on upper GI motility. Five subjects were studied on three separate days following administration of saline placebo and subsequent IV bolus dose of atilmotin (6, 30 or 150 µg). Another five subjects were studied at the highest dose (150 µg). Results Atilmotin at 150 µg increased proximal gastric pressure by 6.5 mmHg (P = 0.001 compared with placebo). Atilmotin increased LES pressure at all studied doses; LES pressure increased from 24 ± 2 mmHg following placebo injection to 34 ± 4 mmHg following a 30 µg dose of atilmotin (P = 0.007). In the esophagus, atilmotin increased the percentage of failed swallows at the highest dose studied. Failed swallows increased from 17 ± 7% following placebo injection to 36 ± 7% following a 150 µg dose of atilmotin (P = 0.016). Atilmotin decreased distal esophageal contractile amplitude only at the highest dose studied, from 69 ± 8 mmHg (placebo) to 50 ± 5 mmHg following 150 µg atilmotin (P = 0.018). There were no serious adverse effects or episodes of chest pain with atilmotin. Conclusions Atilmotin affects esophageal, LES, and gastric motility. LES and gastric pressures were increased, whereas there was disruption of esophageal peristalsis characterized by lower amplitude and failed contractions.

Korimilli, Annapurna

2010-01-01

344

Functional luminal imaging probe topography: an improved method for characterizing esophageal distensibility in eosinophilic esophagitis  

PubMed Central

Objectives: The aims of this study were to develop a new method for analysis and presentation of esophageal distensibility data using high-resolution impedance planimetry recordings during a volume-controlled distention. Methods: Two control subjects and six patients with eosinophilic esophagitis (EoE) with stricture, narrow caliber or normal endoscopy according to EndoFLIP studies were included for analysis. Median filtering and pulse detection techniques were applied to the pressure signal and a wavelet decomposition technique was applied to the 16 channels of raw esophageal diameter data to reduce vascular artifact, respiratory effect and remove esophageal contraction interference. These data were used to generate a functional luminal imaging probe (FLIP) topography plot that describes regional variation of cross-sectional area (CSA). A previously developed computer program was used to calculate and model the CSA-pressure data to derive the slope of line fitting and distension plateau for each individual subject. The results were compared among the four endoscopic phenotypes. Results: Patients with EoE and normal endoscopy had similar esophageal distensibility parameters to those of normal controls whereas patients with EoE and stricture or narrow caliber had much lower distensibility than patients with EoE and normal endoscopy. The FLIP topography plots provided a global assessment of the esophageal distensibility along the axial plane of measurement that differentiated patients with varying degrees of endoscopic abnormality. Conclusions: New techniques can be leveraged to improve data analysis and presentation using EndoFLIP assessment of the esophageal body in EoE. These techniques may be helpful in defining clinically relevant phenotypes and guiding treatment strategies and should be helpful in structuring future outcome trials.

Kahrilas, Peter J.; Xiao, Yinglian; Nicodeme, Frederic; Gonsalves, Nirmala; Hirano, Ikuo; Pandolfino, John E.

2013-01-01

345

Screening pre-bariatric surgery patients for esophageal disease with esophageal capsule endoscopy  

PubMed Central

AIM: To determine if esophageal capsule endoscopy (ECE) is an adequate diagnostic alternative to esophagogastroduodenoscopy (EGD) in pre-bariatric surgery patients. METHODS: We conducted a prospective pilot study to assess the diagnostic accuracy of ECE (PillCam ESO2, Given Imaging) vs conventional EGD in pre-bariatric surgery patients. Patients who were scheduled for bariatric surgery and referred for pre-operative EGD were prospectively enrolled. All patients underwent ECE followed by standard EGD. Two experienced gastroenterologists blinded to the patient’s history and the findings of the EGD reviewed the ECE and documented their findings. The gold standard was the findings on EGD. RESULTS: Ten patients with an average body mass index of 50 kg/m2 were enrolled and completed the study. ECE identified 11 of 14 (79%) positive esophageal/gastroesophageal junction (GEJ) findings and 14 of 17 (82%) combined esophageal and gastric findings identified on EGD. Fisher’s exact test was used to compare the findings and no significant difference was found between ECE and EGD (P = 0.64 for esophageal/GEJ and P = 0.66 for combined esophageal and gastric findings respectively). Of the positive esophageal/GEJ findings, ECE failed to identify the following: hiatal hernia in two patients, mild esophagitis in two patients, and mild Schatzki ring in two patients. ECE was able to identify the entire esophagus in 100%, gastric cardia in 0%, gastric body in 100%, gastric antrum in 70%, pylorus in 60%, and duodenum in 0%. CONCLUSION: There were no significant differences in the likelihood of identifying a positive finding using ECE compared with EGD in preoperative evaluation of bariatric patients.

Shah, Ashish; Boettcher, Erica; Fahmy, Marianne; Savides, Thomas; Horgan, Santiago; Jacobsen, Garth R; Sandler, Bryan J; Sedrak, Michael; Kalmaz, Denise

2013-01-01

346

A striking local esophageal cytokine expression profile in eosinophilic esophagitis1  

PubMed Central

Background Eosinophilic esophagitis (EE) is an emerging worldwide disease that mimics gastroesophageal reflux disease. Objective Early studies have suggested that esophageal eosinophilia occurs in association with T helper type 2 allergic responses, yet the local and systemic expression of relevant cytokines has not been well characterized. Methods A human inflammatory cytokine and receptor PCR array containing 84 genes followed by PCR validation and multiplex arrays were used to quantify cytokine mRNA in esophageal biopsies and blood levels. Results Esophageal transcripts of numerous chemokines [e.g. CCL1, CCL23, CCL26 (eotaxin-3), CXCL1, and CXCL2], cytokines (e.g. IL13 and ABCF1), and cytokine receptors (e.g. IL5RA) were induced at least 4-fold in individuals with EE. Analysis of esophageal biopsies (n=288) revealed that eotaxin-3 mRNA level alone had 89% sensitivity for distinguishing EE from non-EE individuals. The presence of allergy was associated with significantly increased esophageal expression of IL4 and IL5 mRNA in active EE patients. We identified 8 cytokines (IL-4, IL-13, IL-5, IL-6, IL-12p70, CD40L, IL-1?, and IL-17) whose blood levels retrospectively distinguished 12 non-EE from 13 EE patients with 100% specificity and 100% sensitivity. When applied to a blinded, prospectively recruited group of 36 patients, the cytokine panel scoring system had a 79% positive predictive value, 68% negative predictive value, 61% sensitivity, and 83% specificity for identifying EE. Conclusion Evidence is presented that IL13 and IL5 associate with eosinophil and eotaxin-3 levels, indicating the key role of adaptive Th2 immunity in regulating eotaxin-3-driven esophageal eosinophilia in the absence of a consistent systemic change in cytokines.

Blanchard, Carine; Stucke, Emily M.; Rodriguez-Jimenez, Beatriz; Burwinkel, Karen; Collins, Margaret H.; Ahrens, Annette; Alexander, Eileen S.; Butz, Bridget K. Buckmeier; Jameson, Sean C.; Kaul, Ajay; Franciosi, James P.; Kushner, Jonathan P.; Putnam, Philip E.; Abonia, J. Pablo; Rothenberg, Marc E.

2011-01-01

347

Staging and preoperative evaluation of upper gastrointestinal malignancies  

Microsoft Academic Search

Esophageal and gastric cancers are distinct carcinomas of the upper gastrointestinal tract, although the distinction between them becomes less clear at the gastroesophageal junction (GEJ). Increasingly accurate staging is possible based on newer radiographic and surgical techniques such as positron emission tomography (PET), laparoscopy and thoracoscopy, laparoscopic ultrasound, and endoscopic ultrasound (EUS). For both cancer types, tumor classification is determined

Eddie K. Abdalla; Peter W. T. Pisters

2004-01-01

348

Detection of esophageal ulcerations with technetium-99m albumin sucralfate  

SciTech Connect

Technetium-99m albumin-sucralfate ((/sup 99m/Tc)Su) can be used to demonstrate peptic ulcer disease in man and animals. We evaluated the usefulness of (/sup 99m/Tc)Su for detecting various grades of esophagitis. (/sup 99m/Tc)Su adhered to the distal esophagus for up to 3 hr in five of six patients with esophageal ulcers but adhered to only two of nine with lesser degrees of esophagitis. No adherence was seen in five patients without esophagitis. Thus, (/sup 99m/Tc)Su may not be useful for detecting any but the most severe grade of esophagitis. Based on these results, we speculate that the previously documented beneficial effects of sucralfate on mild to moderate esophagitis may be due to other mechanisms besides adherence to the ulcerated mucosa.

Goff, J.S.; Adcock, K.A.; Schmelter, R.

1986-07-01

349

Ergonovine-provoked esophageal spasm during coronary angiography  

SciTech Connect

In many patients with chest pain of esophageal origin, findings are normal on routine esophageal manometry and dysmotility develops only upon provocation with ergonovine maleate. Unfortunately, ergonovine may induce myocardial ischemia in patients in whom coronary artery spasm did not occur during previous provocative testing in a cardiac laboratory - limiting its clinical usefulness. Esophageal pressure has been recorded simultaneously with ergonovine infusion during angiography in ten patients without significant arterial stenoses. In two patients their usual chest pain developed associated with esophageal spasm and without changes in coronary vessels. Simultaneous performance of angiography and manometry enhanced the diagnostic yield of provocative testing by showing esophageal motility changes. This method may detect significant changes in the esophageal motility, is easy to carry out and does not interfere with angiography. It maximizes the information gained from a single provocative test and avoids the risk of ergonovine infusion outside of a cardiac laboratory.

Lieberman, D.A.; Jendrzejewski, J.W.; McAnulty, J.H.

1983-03-01

350

Molecular factors related to metastasis of esophageal squamous cell carcinoma  

Microsoft Academic Search

The aggressive behavior of esophageal cancer leads to a low survival rate for patients with this disease. Isolated esophageal\\u000a cancer cells seem to have the potential for regrowth and metastasis. To control the metastasis of esophageal carcinoma, detailed\\u000a analysis of various molecular and biological factors should be done in each patient. Recent progress in molecular biology\\u000a has revealed that oncogenes,

Yutaka Shimada; Fumiaki Sato

2007-01-01

351

Diet, Lifestyle and Gender in Gastro-Esophageal Reflux Disease  

Microsoft Academic Search

Background Studies indicate that gastro-esophageal reflux disease (GERD) is associated with obesity, smoking, esophagitis, diet, and\\u000a lifestyle. Aim To identify risk factors associated with GERD among patients presenting to a tertiary GI clinic in Italy. Methods Patients with a first diagnosis of GERD based on heartburn and\\/or regurgitation and\\/or esophagitis at the endoscopic examination\\u000a were enrolled. A control group with

Maria Pina Dore; Emmanouil Maragkoudakis; Ken Fraley; Antonietta Pedroni; Vincenza Tadeu; Giuseppe Realdi; David Y. Graham; Giuseppe Delitala; Hoda M. Malaty

2008-01-01

352

Esophageal lipomatosis: another consequence of the use of steroids  

Microsoft Academic Search

.   After we incidentally found on CT extensive esophageal fat accumulations in a patient with long-term use of steroids, we\\u000a prospectively evaluated during a 6-month period all CT studies of the chest for esophageal lipomatosis and related the findings\\u000a to the possible use of steroids. The diagnosis of esophageal fat on CT was made by density measurements or if too

J. Bogaert; F. Rosseel; S. Verhaegen; J. Verschakelen

2000-01-01

353

The role of pepsin in acid injury to esophageal epithelium  

Microsoft Academic Search

OBJECTIVES:The development of reflux esophagitis in humans is a process resulting from esophageal exposure to refluxed gastric contents. There is no doubt that damage to the esophageal epithelium requires exposure to gastric acid; however, the role of refluxed pepsin as contributor to this damage seems to be underappreciated.METHODS:The role of physiological concentrations of pepsin was examined in Ussing chambered rabbit

Nelia A. Tobey; S. Seraj Hosseini; Canan Caymaz-Bor; Holly R. Wyatt; Geraldine S. Orlando; Roy C. Orlando

2001-01-01

354

Ambulatory 24-hour esophageal pH monitoring  

Microsoft Academic Search

If 24-hour esophageal pH monitoring is to be a useful diagnostic tool, it must reliably discriminate gastroesophageal reflux patients despite daily variations in distal esophageal acid exposure. To address this issue, we studied 53 subjects (14 healthy normals, 14 esophagitis patients, and 25 patients with atypical symptoms) with two ambulatory pH tests performed within 10 days of each other. Intrasubject

G. J. Wiener; T. M. Morgan; J. B. Copper; D. O. Castell; J. W. Sinclair; J. E. Richter

1988-01-01

355

Altered esophageal pain threshold in irritable bowel syndrome  

Microsoft Academic Search

Gut motility disorders and altered pain perception were reported in patients with irritable bowel syndrome (IBS). To verify foregut involvement in IBS, we studied 30 patients using esophageal manometry and 24-hr pH monitoring of the distal esophagus. Two subgroups of patients underwent esophageal provocative tests (bethanechol 50 µg\\/kg subcutaneously and esophageal balloon distension test). Twelve healthy volunteers formed a control

Mario Costantini; Giacomo Carlo Sturniolo; Giovanni Zaninotto; Renata D'Incà; Rita Polo; Remo Naccarato; Ermanno Ancona

1993-01-01

356

Carbonated Soft Drink Consumption and Risk of Esophageal Adenocarcinoma  

Microsoft Academic Search

Carbonated soft drinks (CSDs) have been associated with gastroesophageal refl ux, an established risk factor for esophageal adenocarcinoma. As both CSD consumption and esophageal ade- nocarcinoma incidence have sharply increased in recent decades, we exam- ined CSD as a risk factor for esophageal and gastric cancers in a U.S. multi- center, population-based case-control study. Associations between CSD intake and risk

Susan T. Mayne; Harvey A. Risch; Robert Dubrow; Wong-Ho Chow; Marilie D. Gammon; Thomas L. Vaughan; Lauren Borchardt; Janet B. Schoenberg; Janet L. Stanford; A. Brian West; Heidi Rotterdam; William J. Blot; Joseph F. Fraumeni

2006-01-01

357

Impaired Esophageal Bolus Transit in Patients with Gastroesophageal Reflux Disease and Abnormal Esophageal Acid Exposure  

PubMed Central

Background/Aims We assessed the bolus transit and motility characteristics in gastroesophageal reflux disease (GERD) patients with abnormal esophageal pH monitoring. Methods We retrospectively reviewed the combined impedance-esophageal manometry data from consecutive patients who had abnormal acid exposure during 24-hour esophageal pH monitoring. We compared these data to the results from functional heartburn (FH) and asymptomatic volunteers. Results The data from 33 GERD patients (mean age of 51 years, 18 males), 14 FH patients (mean age of 51 years, one male), and 20 asymptomatic volunteers (mean age of 27 years, nine males) were analyzed. Ineffective esophageal motility was diagnosed in 10% of the volunteers, 21% of the FH patients, and 15% of the GERD patients. Ineffective contraction was more frequent in GERD and FH patients than in volunteers (16% and 20% vs 6%, respectively; p<0.05). Additionally, 10% of the volunteers, 21% of the FH patients and 36% of the GERD patients had an abnormal bolus transit. Complete bolus transit was less frequent, and bolus transit was slower in GERD patients than in volunteers for liquid (70% vs 85%) and viscous swallows (57% vs 73%). A longer acid clearance time was associated with abnormal bolus transit in the GERD group. Conclusions Patients with GERD have mild peristaltic dysfunction and incomplete and slower esophageal bolus transit. These conditions predispose them to prolonged acid contact with the esophagus.

Cho, Yu Kyung; Lim, Chul Hyun; Kim, Jin Su; Park, Jae Myung; Lee, In Seok; Kim, Sang Woo; Choi, Kyu-Yong

2012-01-01

358

Apolipocrustacein, formerly vitellogenin, is the major egg yolk precursor protein in decapod crustaceans and is homologous to insect apolipophorin II/I and vertebrate apolipoprotein B  

PubMed Central

Background In animals, the biogenesis of some lipoprotein classes requires members of the ancient large lipid transfer protein (LLTP) superfamily, including the cytosolic large subunit of microsomal triglyceride transfer protein (MTP), vertebrate apolipoprotein B (apoB), vitellogenin (Vtg), and insect apolipophorin II/I precursor (apoLp-II/I). In most oviparous species, Vtg, a large glycolipoprotein, is the main egg yolk precursor protein. Results This report clarifies the phylogenetic relationships of LLTP superfamily members and classifies them into three families and their related subfamilies. This means that the generic term Vtg is no longer a functional term, but is rather based on phylogenetic/structural criteria. In addition, we determined that the main egg yolk precursor protein of decapod crustaceans show an overall greater sequence similarity with apoLp-II/I than other LLTP, including Vtgs. This close association is supported by the phylogenetic analysis, i.e. neighbor-joining, maximum likelihood and Bayesian inference methods, of conserved sequence motifs and the presence of three common conserved domains: an N-terminal large lipid transfer module marker for LLTP, a DUF1081 domain of unknown function in their central region exclusively shared with apoLp-II/I and apoB, and a von Willebrand-factor type D domain at their C-terminal end. Additionally, they share a conserved functional subtilisin-like endoprotease cleavage site with apoLp-II/I, in a similar location. Conclusion The structural and phylogenetic data presented indicate that the major egg yolk precursor protein of decapod crustaceans is surprisingly closely related to insect apoLp-II/I and vertebrate apoB and should be known as apolipocrustacein (apoCr) rather than Vtg. These LLTP may arise from an ancient duplication event leading to paralogs of Vtg sequences. The presence of LLTP homologs in one genome may facilitate redundancy, e.g. involvement in lipid metabolism and as egg yolk precursor protein, and neofunctionalization and subfunctionalization, e.g. involvement in clotting cascade and immune response, of extracellular LLTP members. These protein-coding nuclear genes may be used to resolve phylogenetic relationships among the major arthropod groups, especially the Pancrustacea-major splits.

Avarre, Jean-Christophe; Lubzens, Esther; Babin, Patrick J

2007-01-01

359

Esophageal Carcinoma in African Americans: A Five-Decade Experience  

Microsoft Academic Search

Background  Esophageal cancer accounts for a considerable proportion of carcinomas of the upper gastrointestinal tract in African Americans.\\u000a Our aim was to describe the epidemiology of esophageal squamous cell cancer (ESCC) and esophageal adenocarcinoma (EA) among\\u000a African Americans in the last five decades.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  A total of 601 records of patients with documented esophageal cancer between 1959 and 2007 at Howard University

Hassan Ashktorab; Zahra Nouri; Mehdi Nouraie; Hadi Razjouyan; Edward E. Lee; Ehsan Dowlati; El-Waleed El-Seyed; Adeyinka Laiyemo; Hassan Brim; Duane T. Smoot

360

Prospective evaluation of biopsy number for the diagnosis of viral esophagitis in patients with HIV infection and esophageal ulcer  

Microsoft Academic Search

Background: Establishing a diagnosis of viral esophagitis in patients with human immunodeficiency virus (HIV) infection has important clinical relevance. However, the number of biopsies required to diagnose viral esophagitis is currently unknown. Methods: Over a 34-month period, all HIV-infected patients with esophageal ulcer underwent 10 biopsies of the largest and\\/or most accessible lesion, primarily from the ulcer base. The first

C. Mel Wilcox; Robert F. Straub; David A. Schwartz

1996-01-01

361

Eosinophilic Esophagitis in Brazilian Pediatric Patients  

PubMed Central

We examined 11 pediatric patients with eosinophilic esophagitis with a tardy diagnosis. The symptoms were initially thought to be related to other diseases, leading to the use of inadequate therapeutic approaches. The patients were between 3 and 17 years old (mean 7.8 ± 3.8 years), and 8 of the patients were male. Common symptoms included abdominal pain, regurgitation, difficulty in gaining weight, vomiting, dysphagia, and coughing. The mean age for the onset of symptoms was 4.3 ± 2.9 years. Endoscopic findings included normal mucosa in five (45%) patients, thickening of the mucosa with longitudinal grooves in three (27%), erosive esophagitis in two (18%), and a whitish stippling in one (9%) patient. Treatment included the use of a topical corticosteroid for 10 patients. In eight (73%) cases, the treatment made the symptoms disappear. Ten patients underwent histopathological management after treatment, with a decrease in the number of eosinophils.

Pinheiro, Mayra Isabel Correia; de Goes Cavalcanti, Luciano Pamplona; Honorio, Rodrigo Schuler; de Alencar Moreno, Luis Helder; Fortes, Mayara Carvalho; da Silva, Carlos Antonio Bruno

2013-01-01

362

Eosinophilic esophagitis in brazilian pediatric patients.  

PubMed

We examined 11 pediatric patients with eosinophilic esophagitis with a tardy diagnosis. The symptoms were initially thought to be related to other diseases, leading to the use of inadequate therapeutic approaches. The patients were between 3 and 17 years old (mean 7.8 ± 3.8 years), and 8 of the patients were male. Common symptoms included abdominal pain, regurgitation, difficulty in gaining weight, vomiting, dysphagia, and coughing. The mean age for the onset of symptoms was 4.3 ± 2.9 years. Endoscopic findings included normal mucosa in five (45%) patients, thickening of the mucosa with longitudinal grooves in three (27%), erosive esophagitis in two (18%), and a whitish stippling in one (9%) patient. Treatment included the use of a topical corticosteroid for 10 patients. In eight (73%) cases, the treatment made the symptoms disappear. Ten patients underwent histopathological management after treatment, with a decrease in the number of eosinophils. PMID:24106430

Pinheiro, Mayra Isabel Correia; de Góes Cavalcanti, Luciano Pamplona; Honório, Rodrigo Schuler; de Alencar Moreno, Luís Hélder; Fortes, Mayara Carvalho; da Silva, Carlos Antônio Bruno

2013-09-22

363

Reversal of lower esophageal sphincter hypotension and esophageal aperistalsis after treatment for hypothyroidism.  

PubMed

A 65-year-old woman suffered from both chronic gastroesophageal reflux, which was complicated by columnar metaplasia (Barrett's epithelium), and profound hypothyroidism. An esophageal motility tracing showed absence of peristalsis in the lower esophagus and the lower esophageal sphincter (LES) could not be identified. Thyroid replacement therapy, in conjunction with antacid and cimetidine treatment, was associated not only with improvement in the gastroesophageal reflux symptoms, but also with a return of esophageal peristalsis and LES pressure to normal. To support our clinical observations, we rendered four cats hypothyroid with 131I and documented a fall in LES pressure. We propose that abnormal smooth-muscle function of the esophagus may be another manifestation of the gastrointestinal motility disturbances which are associated with hypothyroidism. PMID:7119407

Eastwood, G L; Braverman, L E; White, E M; Vander Salm, T J

1982-08-01

364

Pellagra associated with esophageal carcinoma and alcoholism.  

PubMed

Pellagra is a nutritional disease caused by the deficiency of niacin. It presents with a photodistributed rash, gastrointestinal symptoms, and neuropsychiatric disturbances. In the Western world, this disease is mostly confined to alcoholics or the impoverished. However, this condition must be recognized in other clinical settings because it is easily treated and can be fatal if not identified. We describe a case of pellagra caused by esophageal carcinoma and alcoholism; we also review the literature. PMID:19624986

Nogueira, Ana; Duarte, Ana F; Magina, Sofia; Azevedo, Filomena

2009-05-15

365

Eosinophilic Esophagitis in Infants and Toddlers  

Microsoft Academic Search

Feeding refusal is often described in conjunction with the diagnosis of eosinophilic esophagitis (EE) in pediatric patients;\\u000a however, there are little data regarding the specific clinical manifestations and effective management of this condition in\\u000a very young children. The aim of this study was to evaluate the presentation of EE in infants and toddlers referred to the\\u000a Interdisciplinary Feeding Team Clinic

Scott P. Pentiuk; Claire Kane Miller; Ajay Kaul

2007-01-01

366

Medical management of iatrogenic esophageal perforations  

Microsoft Academic Search

Opinion statement  Esophageal perforation is an uncommon, potentially disastrous occurrence with high mortality rates even when managed with\\u000a surgery. Over the past few decades, several case series have shown that nonoperative management is a feasible option in some\\u000a patients, although the criteria for selecting such patients are neither firmly established nor accepted by all those who manage\\u000a these critical patients. The

Ryan D. Madanick

2008-01-01

367

Outcomes in esophageal atresia and tracheoesophageal fistula  

Microsoft Academic Search

Background\\/Purpose: The purpose of this analysis was to investigate outcomes in newborns with esophageal atresia (EA) or tracheoesophageal fistula (TEF) with respect to prognostic classifications and complications.Methods: Charts of all 144 infants with EA\\/TEF treated at British Columbia Children’s Hospital (BCCH) from 1984 to 2000 were reviewed. Patient demographics, frequency of associated anomalies, and details of management and outcomes were

David E Konkin; Wael A O’Hali; Eric M Webber; Geoffrey K Blair

2003-01-01

368

Volumetric modulated arc radiotherapy for esophageal cancer  

Microsoft Academic Search

A treatment planning study was performed to evaluate the performance of volumetric arc modulation with RapidArc (RA) against 3D conformal radiation therapy (3D-CRT) and conventional intensity-modulated radiation therapy (IMRT) techniques for esophageal cancer. Computed tomgraphy scans of 10 patients were included in the study. 3D-CRT, 4-field IMRT, and single-arc and double-arc RA plans were generated with the aim to spare

Nagarajan Vivekanandan; Padmanaban Sriram; S. A. Syam Kumar; Narayanan Bhuvaneswari; Kamalakannan Saranya

369

PET-CT of Esophageal Cancer  

Microsoft Academic Search

\\u000a There is no established role for the use of 18FDG PET in the screening or initial diagnosis of esophageal carcinoma, although\\u000a T4 tumors may be diagnosed with PET-CT. In the detection of distant metastatic lymph nodes and other organ metastases FDG\\u000a PET is more accurate than EUS and CT combined. FDG PET-CT response has been used to guide subsequent treatment.

Gary J. R. Cook

370

Spirocercosis-associated esophageal sarcomas in dogs  

Microsoft Academic Search

Seventeen client-owned dogs diagnosed with spirocercosis-associated esophageal sarcomas were retrospectively reviewed. The most common clinical signs noticed were vomiting and\\/or regurgitation (94%), lethargy and depression (59%), pyrexia and anorexia (41% each). Leukocytosis (82%) and microcytic hypochromic anemia (30%) were the most common hematological abnormalities. Caudal thoracic masses were demonstrated on survey radiographs of 13\\/15 of the dogs and thoracic spondylitis

Eyal Ranen; Eran Lavy; Izhac Aizenberg; Shmuel Perl; Shimon Harrus

2004-01-01

371

Treatment of esophageal spirocercosis with milbemycin oxime  

Microsoft Academic Search

Six medium sized mixed breed dogs treated with milbemycin oxime (11.5mg on days 0, 7 and 28 and then monthly) stopped shedding Spirocerca lupi ova after 3–44 days. There was no evidence of subsequent shedding in repeated tests (about 5\\/dog) carried out from 31 to 133 days after initiation of treatment. Esophageal nodules disappeared in all dogs within 95–186 days

P. J. Kelly; M. Fisher; H. Lucas; R. C. Krecek

2008-01-01

372

Pharyngo-Esophageal Dysphagia in Parkinson's Disease  

Microsoft Academic Search

.   The radiologic characteristics of pharyngo-esophageal (PE) dysfunction in Parkinson's disease (PD) are not well established,\\u000a partly because most previous studies have examined only small numbers of patients. We administered a dynamic videofluoroscopic\\u000a swallowing function study to 71 patients with idiopathic PD. Using the Hoehn and Yahr disease severity scale, patients were\\u000a subdivided into those with mild\\/moderate disease, subgroup I

Norman A. Leopold; Marion C. Kagel

1997-01-01

373

Vascular endothelial growth factor in esophageal cancer.  

PubMed

Vascular endothelial growth factor (VEGF) plays a crucial role in angiogenesis of many solid malignancies. The influence of angiogenesis and VEGF expression on progression and recurrence of esophageal cancer has been investigated over the last years. This article reviews the prognostic significance of VEGF expression, microvessel density (MVD), and lymphangiogenic factors in squamous cell carcinoma (SCC), Barrett's dysplasia, and adenocarcinoma (AC) of the esophagus, their predictive value for treatment response to chemo-radiotherapy and new anti-angiogenic treatment strategies. PMID:15282704

Kleespies, Axel; Guba, Markus; Jauch, Karl-Walter; Bruns, Christiane J

2004-08-01

374

Unusual Esophageal Foreign Body: A Table Fork  

PubMed Central

The presence of an esophageal foreign body (EFB) is a medical emergency requiring urgent evaluation and treatment. Swallowing of foreign bodies is most common in children aged between 6 months and 6 years, in whom it usually occurs during games. In adults, foreign bodies tend to be ingested accidentally together with food. The authors report an unusual case of EFB (a table fork) in an adult and briefly report the clinical presentation and the therapeutic procedures adopted in this case and similar cases.

Mevio, Emilio; Mevio, Niccolo

2013-01-01

375

Acute esophageal necrosis: a rare syndrome  

Microsoft Academic Search

Background  Acute esophageal necrosis, which presents as a black esophagus on endoscopy, is a rare disorder that is poorly described in\\u000a the medical literature. In this study, we analyze all cases reported to date to define risk factors, clinical presentation,\\u000a endoscopic features, histologic appearance, treatment, complications, outcome and etiopathogenesis of the disease and to describe\\u000a a distinct medical syndrome and propose

Grigoriy E. Gurvits; Alexander Shapsis; Nancy Lau; Nicholas Gualtieri; James G. Robilotti

2007-01-01

376

[Principles of treatment in locally advanced esophageal squamous cancer].  

PubMed

The diagnosis established in the symptomatic phase of this disease, most often occurs at advanced stage neoplasia. The purpose of this article is to establish the place and method of surgical and radio-chemo therapy in advanced loco-regional squamous esophageal neoplasm (stage IIB-III). Surgical treatment establishes the best results over long periods of time, however, this is done keeping in mind acceptable morbidity and mortality conditions. Multimodal treatment is encompassed in general efforts to achieve optimal results along with increasing the quantity and quality of life. Neoadjuvant radiochemotherapy (CRT) increases practitioners' possibility of resecting tumors, decreasing their size, and establishing proper means of local (radiotherapy) and systemic (chemotherapy) control. Great efforts are made in finding markers which lead to correct diagnosis and treatment options that will further permit nonresponsive radio and chemo therapy treated patients from experiencing unwanted toxicity. The role of adjuvant therapy is that of decreasing recurrence in patients with residual mediastinal disease after palliative surgical resection. Palliative treatment consists of improving dysphagia, and the quality of life using surgical, endoscopic, photodynamic, laser, radio and chemotherapy as alternatives. PMID:20405674

Constantinoiu, S; Hanna, A; Bîrl?, R; Anghel, R; Tavlas, E; Mocanu, A; Hoar?, P

377

Glycemic index, carbohydrate and fiber intakes and risk of reflux esophagitis, Barrett’s esophagus, and esophageal adenocarcinoma  

Microsoft Academic Search

Objective  To examine the association between dietary glycemic index (GI), glycemic load (GL), total carbohydrate, sugars, starch, and\\u000a fiber intakes and the risk of reflux esophagitis, Barrett’s esophagus, and esophageal adenocarcinoma.\\u000a \\u000a \\u000a \\u000a Methods  In an all-Ireland study, dietary information was collected from patients with esophageal adenocarcinoma (n = 224), long-segment Barrett’s esophagus (n = 220), reflux esophagitis (n = 219), and population-based controls (n = 256). Multiple logistic regression analysis examined

Helen G. Mulholland; Marie M. Cantwell; Lesley A. Anderson; Brian T. Johnston; R. G. Peter Watson; Seamus J. Murphy; Heather R. Ferguson; Jim McGuigan; John V. Reynolds; Harry Comber; Liam J. Murray

2009-01-01

378

Plastic tube-assisted gastroscopic removal of embedded esophageal metal stents: A case report.  

PubMed

A patient with stent embedding after placement of an esophageal stent for an esophagobronchial fistula was treated with an ST-E plastic tube inserted into the esophagus to the upper end of the stent using gastroscopy. The gastroscope was guided into the esophagus through the ST-E tube, and an alligator forceps was inserted into the esophagus through the ST-E tube alongside the gastroscope. Under gastroscopy, the stent wire was grasped with the forceps and pulled into the ST-E tube. When resistance was met during withdrawal, the gastroscope was guided further to the esophageal section where the stent was embedded. Biopsy forceps were guided through a biopsy hole in the gastroscope to the embedded stent to remove silicone membranes and connection threads linking the Z-shaped wire mesh. While the lower section of the Z-shaped stent was fixed by the biopsy forceps, the alligator forceps were used to pull the upper section of the metal wire until the Z-shaped metal loops elongated. The wire mesh of the stent was then removed in stages through the ST-E tube. Care was taken to avoid bleeding and perforation. Under the assistance of an ST-E plastic tube, an embedded esophageal metal stent was successfully removed with no bleeding or perforation. The patient experienced an uneventful recovery after surgery. Plastic tube-assisted gastroscopic removal of embedded metal stents can be minimally invasive, safe, and effective. PMID:24151373

Peng, Gui-Yong; Kang, Xiu-Feng; Lu, Xin; Chen, Lei; Zhou, Qian

2013-10-14

379

Plastic tube-assisted gastroscopic removal of embedded esophageal metal stents: A case report  

PubMed Central

A patient with stent embedding after placement of an esophageal stent for an esophagobronchial fistula was treated with an ST-E plastic tube inserted into the esophagus to the upper end of the stent using gastroscopy. The gastroscope was guided into the esophagus through the ST-E tube, and an alligator forceps was inserted into the esophagus through the ST-E tube alongside the gastroscope. Under gastroscopy, the stent wire was grasped with the forceps and pulled into the ST-E tube. When resistance was met during withdrawal, the gastroscope was guided further to the esophageal section where the stent was embedded. Biopsy forceps were guided through a biopsy hole in the gastroscope to the embedded stent to remove silicone membranes and connection threads linking the Z-shaped wire mesh. While the lower section of the Z-shaped stent was fixed by the biopsy forceps, the alligator forceps were used to pull the upper section of the metal wire until the Z-shaped metal loops elongated. The wire mesh of the stent was then removed in stages through the ST-E tube. Care was taken to avoid bleeding and perforation. Under the assistance of an ST-E plastic tube, an embedded esophageal metal stent was successfully removed with no bleeding or perforation. The patient experienced an uneventful recovery after surgery. Plastic tube-assisted gastroscopic removal of embedded metal stents can be minimally invasive, safe, and effective.

Peng, Gui-Yong; Kang, Xiu-Feng; Lu, Xin; Chen, Lei; Zhou, Qian

2013-01-01

380

The intracellular II-III loops of Cav1.2 and Cav1.3 uncouple L-type voltage-gated Ca2+ channels from glucagon-like peptide-1 potentiation of insulin secretion in INS-1 cells via displacement from lipid rafts.  

PubMed

L-type Ca(2+) channels play a key role in the integration of physiological signals regulating insulin secretion that probably requires their localization to specific subdomains of the plasma membrane. We investigated the role of the intracellular II-III loop domains of the L-type channels Ca(v)1.2 and 1.3 in coupling of Ca(2+) influx with glucose-stimulated insulin secretion (GSIS) potentiated by the incretin hormone glucagon-like peptide (GLP)-1. In INS-1 cell lines expressing the Ca(v)1.2/II-III or Ca(v)1.3/II-III peptides, GLP-1 potentiation of GSIS was inhibited markedly, coincident with a decrease in GLP-1-stimulated cAMP accumulation and the redistribution of Ca(v)1.2 and Ca(v)1.3 out of lipid rafts. Neither the Ca(v)1.2/II-III nor the Ca(v)1.3/II-III peptide decreased L-type current density compared with untransfected INS-1 cells. GLP-1 potentiation of GSIS was restored by the L-type channel agonist 2,5-dimethyl-4-[2-(phenylmethyl)benzoyl]-1H-pyrrole-3-carboxylic acid methyl ester (FPL-64176). In contrast, potentiation of GSIS by 8-bromo-cAMP (8-Br-cAMP) was inhibited in Ca(v)1.2/II-III but not Ca(v)1.3/II-III cells. These differences may involve unique protein-protein interactions because the Ca(v)1.2/II-III peptide, but not the Ca(v)1.3/II-III peptide, immunoprecipitates Rab3-interacting molecule (RIM) 2 from INS-1 cell lysates. RIM2, and its binding partner Piccolo, localize to lipid rafts, and they may serve as anchors for Ca(v)1.2 localization to lipid rafts in INS-1 cells. These findings suggest that the II-III interdomain loops of Ca(v)1.2, and possibly Ca(v)1.3, direct these channels to membrane microdomains in which the proteins that mediate potentiation of GSIS by GLP-1 and 8-Br-cAMP assemble. PMID:19351867

Jacobo, Sarah Melissa P; Guerra, Marcy L; Jarrard, Rachel E; Przybyla, Julie A; Liu, Guohong; Watts, Val J; Hockerman, Gregory H

2009-04-07

381

A new endoscopic technique for suspension of esophageal prosthesis for refractory caustic esophageal strictures.  

PubMed

There is no clear consensus concerning the best endoscopic treatment of benign refractory esophageal strictures due to caustic ingestion. Different procedures are currently used: frequent multiple dilations, retrievable self-expanding stent, nasogastric intubation and surgery. We describe a new technique to fix a suspended esophageal silicone prosthesis to the neck in benign esophageal strictures; this permits us to avoid the frequent risk of migration of the expandable metallic or plastic stents. Under general anesthesia a rigid esophagoscope was placed in the patient's hypopharynx. Using transillumination from the optical device, the patient's neck was pierced with a needle. A n.0 monofilament surgical wire was pushed into the needle, grasped by a standard foreign body forceps through the esophagoscope and pulled out of the mouth (as in percutaneous endoscopic gastrostomy procedure). After tying the proximal end of the silicone prosthesis with the wire, it was placed through the strictures under endoscopic view. This procedure was successfully utilized in four patients suffering from benign refractory esophageal strictures due to caustic ingestion. The prosthesis and its suspension from the neck were well-tolerated until removal (mean duration 4 months). A postoperative transitory myositis was diagnosed in only one patient. One of the most frequent complications of esophageal prostheses in refractory esophageal strictures due to caustic ingestion is distal migration. Different solutions were proposed. For example the suspension of a wire coming from the nose and then fixed behind the ear. This solution is not considered optimal because of patient complaints and moreover the aesthetic aspect is compromised. The procedure we utilized in four patients utilized the setting of a silicone tube hanging from the neck in a way similar to that of endoscopic pharyngostomy. This solution is a valid alternative both for quality of life and for functional results. PMID:18430109

Ancona, E; Guido, E; Cutrone, C; Bocus, P; Rampado, S; Vecchiato, M; Salvador, R; Donach, M; Battaglia, G

2008-01-01

382

Herpes simplex ulcerative esophagitis in healthy children.  

PubMed

Herpes simplex virus is a common cause of ulcerative esophagitis in the immunocompromised or debilitated host. Despite a high prevalence of primary and recurrent Herpes simplex virus infection in the general population, Herpes simplex virus esophagitis (HSVE) appears to be rare in the immunocompetent host. We report three cases of endoscopically-diagnosed HSVE in apparently immunocompetent children; the presentation was characterized by acute onset of fever, odynophagia, and dysphagia. In two cases, the diagnosis was confirmed histologically by identification of herpes viral inclusions and culture of the virus in the presence of inflammation. The third case was considered to have probable HSVE based on the presence of typical cold sore on his lip, typical endoscopic finding, histopathological evidence of inflammation in esophageal biopsies and positive serologic evidence of acute Herpes simplex virus infection. Two cases received an intravenous course of acyclovir and one had self-limited recovery. All three cases had normal immunological workup and excellent health on long-term follow-up. PMID:21912064

Al-Hussaini, Abdulrahman A; Fagih, Mosa A

383

Benign esophageal schwannoma: report of a case.  

PubMed

We report herein the case of an otherwise asymptomatic 62-year-old woman who was found to have an incidental esophageal lesion during endoscopic follow-up of an unrelated disorder. An esophageal submucosal tumor was diagnosed, and the patient was subsequently monitored on a regular yearly basis. As the diameter of the tumor doubled over a 4-year period, the possibility of a malignant lesion could not be excluded, and she was admitted to our hospital for further investigations. Esophagography, endoscopy, endoscopic ultrasonography, and computed tomography confirmed a submucosal tumor, 35 mm in length, in the thoracic midesophagus. A leiomyoma or leiomyosarcoma was suspected based on the known incidence of such tumors, and tumor enucleation was performed. Gross inspection revealed a solid tumor arising from the wall of the esophagus. Histopathologic examination showed intertwined bundles of spindle cells with spiral-like proliferation, and immunohistochemical studies were positive for S-100 protein, whereby a diagnosis of esophageal schwannoma was established. The patient experienced no postoperative complications, and her clinical course to date has been satisfactory. To date, 2 years 8 months after surgery, she has shown no sign of tumor recurrence and remains in good health. PMID:10883464

Kobayashi, N; Kikuchi, S; Shimao, H; Hiki, Y; Kakita, A; Mitomi, H; Ohbu, M

2000-01-01

384

Esophageal pulse oximetry utilizing reflectance photoplethysmography.  

PubMed

Peripheral perfusion is often poor and barely pulsatile in patients undergoing prolonged major surgery. Hence, the arterial blood oxygen saturation (SpO2) readings from commercial finger pulse oximeters can become unreliable or cease when they are most needed. To overcome this limitation, the esophagus has been investigated as an alternative measurement site, as perfusion may be preferentially preserved centrally. A reflectance esophageal pulse oximeter probe, and a processing system implemented in LabVIEW were developed. The system was evaluated in clinical measurements on 49 cardiothoracic surgery patients. The SpO2 values from the esophagus were in good agreement with arterial blood oxygen saturation (SaO2) values obtained from blood gas analysis and CO-oximetry. The means (+/-SD) of the differences between the esophageal SpO2 and SaO2 results from blood gas analysis and CO-oximetry were 0.02 +/- 0.88% and -0.73 +/- 0.72%, respectively. In five (10.2%) of the patients, the finger pulse oximeter failed for at least 10 min while the esophageal SpO2 readings remained reliable. The results confirm that the esophagus may be used as an alternative monitoring site for pulse oximetry even in patients with compromised peripheral perfusion. PMID:12450366

Kyriacou, Panayiotis A; Powell, Sarah; Langford, Richard M; Jones, Deric P

2002-11-01

385

Correlation among 16 biological factors [p53, p21waf1, MIB-1 (Ki-67), p16INK4A, cyclin D1, E-cadherin, Bcl-2, TNF-?, NF-?B, TGF-?, MMP-7, COX-2, EGFR, HER2/neu, ER, and HIF-1?] and clinical outcomes following curative chemoradiation therapy in 10 patients with esophageal squamous cell carcinoma  

PubMed Central

The expression levels of 16 proteins were analyzed to identify prognostic correlations in esophageal squamous cell carcinoma (ESCC) treated with concurrent chemoradiation therapy (CCRT). The immunohistochemical expression levels of p53, p21waf1, molecular immunology borstel-1 (MIB-1, Ki-67), p16INK4A, cyclin D1, E-cadherin, Bcl-2, tumor necrosis factor (TNF)-?, nuclear factor (NF)-?B, transforming growth factor (TGF)-?, matrix metalloproteinase (MMP)-7, cyclooxygenase (COX)-2, epidermal growth factor receptor (EGFR), human EGFR type 2 (HER2/neu), estrogen receptor (ER) and hypoxia-inducible factor (HIF)-1? were studied in 10 cases of ESCC treated with CCRT. The patients underwent CCRT between 2000 and 2010. The mean patient age was 68.1 years (range, 46-80 years). The numbers of patients in stages I, II, III and IV of the disease were 2, 2, 3 and 3, respectively. Of the tumors, 8 were positive for p53, 6 for p21waf1, 7 for MIB-1 (Ki-67), 7 for p16INK4A, 7 for cyclin D1, 8 for E-cadherin, 3 for Bcl-2, 0 for TNF-?, 5 for NF-?B, 7 for TGF-?, 9 for MMP-7, 7 for COX-2, 5 for EGFR, 1 for HER2/neu, 1 for ER and 7 for HIF-1?. The 2-year overall survival rate of patients expressing high levels of MIB-1 was 71% (±17%) compared with 0% (P=0.019) for those expressing low levels. For NF-?B, the rate was 0% for patients with high levels compared with 100% (P<0.018) for those with low levels. The 2-year local control rates of HER2/neu were 0% in patients expressing high levels and 88% (±12%) in patients expressing low levels (P=0.027). The 2-year disease-free survival rates of HER2/neu and ER were 0% for patients expressing high levels compared with 56% (±17%) for those with low levels (P=0.027). There were no significant correlations between the expression levels of the other proteins and clinical outcomes. In the present study, high levels of MIB-1 and low levels of NF-?B, HER2 and ER were shown to be good prognostic factors following definitive CCRT for ESCC.

SHIBATA-KOBAYASHI, SHINO; YAMASHITA, HIDEOMI; OKUMA, KAE; SHIRAISHI, KENSHIRO; IGAKI, HIROSHI; OHTOMO, KUNI; NAKAGAWA, KEIICHI

2013-01-01

386

Systematic review of health-related quality of life after esophagectomy for esophageal cancer  

PubMed Central

This study is aimed to assess the long-term health-related quality of life (HRQL) of patients after esophagectomy for esophageal cancer in comparison with es-tablished norms, and to evaluate changes in HRQL during the different stages of follow-up after esophageal resection. A systematic review was performed by searching medical databases (Medline, Embase and the Cochrane Library) for potentially relevant studies that appeared between January 1975 and March 2011. Studies were included if they addressed the question of HRQL after esophageal resection for esophageal cancer. Two researchers independently performed the study selection, data extraction and analysis processes. Twenty-one observational studies were included with a total of 1282 (12-355) patients. Five studies were performed with short form-36 (SF-36) and 16 with European Organization for Research and Treatment of Cancer (EORTC) QLQ C30 (14 of them also utilized the disease-specific OES18 or its previous version OES24). The analysis of long-term generic HRQL with SF-36 showed pooled scores for physical, role and social function after esophagectomy similar to United States norms, but lower pooled scores for physical function, vitality and general health perception. The analysis of HRQL conducted using the Global EORTC C30 global scale during a 6-mo follow-up showed that global scale and physical function were better at the baseline. The symptom scales indicated worsened fatigue, dyspnea and diarrhea 6 mo after esophagectomy. In contrast, however, emotional function had significantly improved after 6 mo. In conclusion, short- and long-term HRQL is deeply affected after esophagectomy for cancer. The impairment of physical function may be a long-term consequence of esophagectomy involving either the respiratory system or the alimentary tract. The short- and long-term improvement in the emotional function of patients who have undergone successful operations may be attributed to the impression that they have survived a near-death experience.

Scarpa, Marco; Valente, Stefano; Alfieri, Rita; Cagol, Matteo; Diamantis, Giorgio; Ancona, Ermanno; Castoro, Carlo

2011-01-01

387

Four-dimensional computed tomographic analysis of esophageal mobility during normal respiration  

SciTech Connect

Background: Chemo-radiotherapy for thoracic tumors can result in high-grade radiation esophagitis. Treatment planning to reduce esophageal irradiation requires organ motion to be accounted for. In this study, esophageal mobility was assessed using four-dimensional computed tomography (4DCT). Methods and Materials: Thoracic 4DCT scans were acquired on a 16-slice CT scanner in 29 patients. The outer esophageal wall was contoured in two extreme phases of respiration in 9 patients with nonesophageal malignancies. The displacement of the center of contour was measured at 2-cm intervals. In 20 additional patients with Stage I lung cancer, the esophagus was contoured in all 10 phases of each 4DCT at five defined anatomic levels. Both approaches were then applied to 4DCT scans of 4 patients who each had two repeat scans performed. A linear mixed effects model was constructed with fixed effects: measurement direction, measurement type, and measurement location along the cranio-caudal axis. Results: Measurement location and direction were significant descriptive parameters (Wald F-tests, p < 0.001), and the interaction term between the two was significant (p = 0.02). Medio-lateral mobility exceeded dorso-ventral mobility in the lower half of the esophagus but was of a similar magnitude in the upper half. Margins that would have incorporated all movement in medio-lateral and dorso-ventral directions were 5 mm proximally, 7 mm and 6 mm respectively in the mid-esophagus, and 9 mm and 8 mm respectively in the distal esophagus. Conclusions: The distal esophagus shows more mobility. Margins for mobility that can encompass all movement were derived for use in treatment planning, particularly for stereotactic radiotherapy.

Dieleman, Edith [Department of Radiation Oncology, VU University Medical Center, Amsterdam (Netherlands); Senan, Suresh [Department of Radiation Oncology, VU University Medical Center, Amsterdam (Netherlands)]. E-mail: s.senan@vumc.nl; Vincent, Andrew [Department of Bioinformatics, Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands); Lagerwaard, Frank J. [Department of Radiation Oncology, VU University Medical Center, Amsterdam (Netherlands); Slotman, Ben J. [Department of Radiation Oncology, VU University Medical Center, Amsterdam (Netherlands); Soernsen de Koste, John R. van [Department of Radiation Oncology, VU University Medical Center, Amsterdam (Netherlands)

2007-03-01

388

Systematic review of health-related quality of life after esophagectomy for esophageal cancer.  

PubMed

This study is aimed to assess the long-term health-related quality of life (HRQL) of patients after esophagectomy for esophageal cancer in comparison with established norms, and to evaluate changes in HRQL during the different stages of follow-up after esophageal resection. A systematic review was performed by searching medical databases (Medline, Embase and the Cochrane Library) for potentially relevant studies that appeared between January 1975 and March 2011. Studies were included if they addressed the question of HRQL after esophageal resection for esophageal cancer. Two researchers independently performed the study selection, data extraction and analysis processes. Twenty-one observational studies were included with a total of 1282 (12-355) patients. Five studies were performed with short form-36 (SF-36) and 16 with European Organization for Research and Treatment of Cancer (EORTC) QLQ C30 (14 of them also utilized the disease-specific OES18 or its previous version OES24). The analysis of long-term generic HRQL with SF-36 showed pooled scores for physical, role and social function after esophagectomy similar to United States norms, but lower pooled scores for physical function, vitality and general health perception. The analysis of HRQL conducted using the Global EORTC C30 global scale during a 6-mo follow-up showed that global scale and physical function were better at the baseline. The symptom scales indicated worsened fatigue, dyspnea and diarrhea 6 mo after esophagectomy. In contrast, however, emotional function had significantly improved after 6 mo. In conclusion, short- and long-term HRQL is deeply affected after esophagectomy for cancer. The impairment of physical function may be a long-term consequence of esophagectomy involving either the respiratory system or the alimentary tract. The short- and long-term improvement in the emotional function of patients who have undergone successful operations may be attributed to the impression that they have survived a near-death experience. PMID:22180708

Scarpa, Marco; Valente, Stefano; Alfieri, Rita; Cagol, Matteo; Diamantis, Giorgio; Ancona, Ermanno; Castoro, Carlo

2011-11-14

389

The Influence of Pretreatment Body Mass Index on Long-Term Prognosis of Patients With Esophageal Carcinoma After Surgery  

PubMed Central

Background: Obesity, which is one of the most serious health problems in United States, is considered a risk factor for lower esophageal and gastric cardia adenocarcinoma. However, the influence of obesity on esophageal cancer survival has not been determined. The aim of this study is to examine the impact of obesity on the long-term mortality outcomes for patients with esophageal cancer after surgery. Methods: A retrospective review was performed of 243 consecutive esophageal cancer patients undergoing surgery who did not receive neoadjuvant therapy. Patients were grouped according to pretreatment body mass index, as normal/underweight (<25 kg/m2) and overweight (?25 kg/m2). Overall and recurrence-free survivals were investigated using Kaplan-Meier method, and Cox regression model was used to determine the significant prognostic factors on univariate and multivariate analysis. Results: There were 67 patients (28%) who were classified as normal/underweight and 176 patients (72%) as overweight. In the overweight group, the numbers of patients who were male (P < .001), with adenocarcinoma (P < .001), and pathologic stage I (p=0.003) were significantly higher than in the normal/underweight group. There was no significant difference in postoperative morbidity rates between the two groups. Both local/regional and distant recurrence rates were significantly higher in the normal/underweight group (P = .027 and P = .039, respectively). The 5-year overall survival rates were 41% in the normal/underweight group, and 67% in the overweight group (P = .002). The 5-year disease free survival rates were 37% in the normal/underweight group, and 65% in the overweight group (P = .001). In univariate analysis, BMI ?25 and lower esophagus tumor were factors associated with longer survival. Factors including older age, weight loss before treatment, smoking history, squamous cell carcinoma, tumor size>3 cm, pathologic stage III, and poorly differentiated carcinoma were significantly associated with shorter patient survival. In multivariate analysis, age, pathologic stage and tumor location ultimately remained as prognostic factors. Lower esophageal tumor (P = .015; HR, 0.386; 95% CI, 0.179–0.833) was related with better survival, and older age (P = .014; HR, 1.032; 95% CI, 1.006–1.057) and stage III disease (P = .015; HR, 6.162; 95% CI, 1.744–21.766) were related with poor survival. Conclusions: Pretreatment BMI cannot be recognized as an independent predictor of long-term prognosis in esophageal cancer patients after surgery. However, high BMI tends to be associated with better prognosis. This work was supported in part by grants from UT M. D. Anderson Cancer Center, Dallas, Park, Cantu, Smith, and Myers families and by the River Creek Foundation.

Hayashi, Yuki; Correa, Arlene M.; Hofstetter, Wayne L.; Vaporciyan, Ara A.; Rice, David C.; Walsh, Garrett L.; Mehran, Reza J.; Swisher, Stephen G.; Ajani, Jaffer A.

2010-01-01

390

High-dose chemoradiotherapy followed by surgery versus surgery alone in esophageal cancer: a retrospective cohort study  

Microsoft Academic Search

BACKGROUND: We aimed to assess whether high-dose preoperative chemoradiotherapy (CRT) improves outcome in esophageal cancer patients compared to surgery alone and to define possible prognostic factors for overall survival. METHODS: Hundred-and-seven patients with disease stage IIA - III were treated with either surgery alone (n = 45) or high-dose preoperative CRT (n = 62). The data were collected retrospectively. Sixty-seven

Meysan Hurmuzlu; Kjell Øvrebø; Odd R Monge; Rune Smaaland; Tore Wentzel-Larsen; Asgaut Viste

2010-01-01

391

Application of whole-body positron emission tomography in the imaging of esophageal cancer: Report of a case  

Microsoft Academic Search

We describe herein a case of esophageal cancer in which both primary and metastatic lymph node foci were successfully imaged with whole-body positron emission tomography (PET) scanning. A 75-year-old woman with biopsy-proven squamous cell carcinoma of the esophagus underwent whole-body PET scanning for staging evaluation. The patient was injected with 373.7 MBq [18F]-2-fluoro-2-d-deoxyglucose (FDG), and 60 min later, scanning was

Seiei Yasuda; Shanker Raja; Karl F. Hubner

1995-01-01

392

The prognostic effect of ethnicity for gastric and esophageal cancer: the population-based experience in British Columbia, Canada  

PubMed Central

Background Gastric and esophageal cancers are among the most lethal human malignancies. Their epidemiology is geographically diverse. This study compares the survival of gastric and esophageal cancer patients among several ethnic groups including Chinese, South Asians, Iranians and Others in British Columbia (BC), Canada. Methods Data were obtained from the population-based BC Cancer Registry for patients diagnosed with invasive esophageal and gastric cancer between 1984 and 2006. The ethnicity of patients was estimated according to their names and categorized as Chinese, South Asian, Iranian or Other. Cox proportional hazards regression analysis was used to estimate the effect of ethnicity adjusted for patient sex and age, disease histology, tumor location, disease stage and treatment. Results The survival of gastric cancer patients was significantly different among ethnic groups. Chinese patients showed better survival compared to others in univariate and multivariate analysis. The survival of esophageal cancer patients was significantly different among ethnic groups when the data was analyzed by a univariate test (p = 0.029), but not in the Cox multivariate model adjusted for other patient and prognostic factors. Conclusions Ethnicity may represent underlying genetic factors. Such factors could influence host-tumor interactions by altering the tumor's etiology and therefore its chance of spreading. Alternatively, genetic factors may determine response to treatments. Finally, ethnicity may represent non-genetic factors that affect survival. Differences in survival by ethnicity support the importance of ethnicity as a prognostic factor, and may provide clues for the future identification of genetic or lifestyle factors that underlie these observations.

2011-01-01

393

Decreased expression of GST pi is correlated with a poor prognosis in human esophageal squamous carcinoma  

PubMed Central

Background Glutathione S-transferase pi (GST pi) is a subgroup of GST family, which provides cellular protection against free radical and carcinogenic compounds due to its detoxifying function. Expression patterns of GST pi have been studied in several carcinomas and its down-regulation was implicated to be involved in malignant transformation in patients with Barrett's esophagus. However, neither the exact role of GST pi in the pathogenesis nor its prognostic impact in squamous esophageal carcinoma is fully characterized. Methods Immunohistochemistry was used to investigate GST pi expression on 153 archival squamous esophageal carcinoma specimens with a GST pi monoclonal antibody. Statistic analyses were performed to explore its association with clinicopathological factors and clinical outcome. Results The GST pi expression was greatly reduced in tissues of esophageal carcinomas compared to adjacent normal tissues and residual benign tissues. Absent of GST pi protein expression in cytoplasm, nuclear and cytoplasm/nucleus was found in 51%, 64.7% and 48% of all the carcinoma cases, respectively. GST pi deficiency in cytoplasm, nucleus and cytoplasm/nucleus was significantly correlated to poor differentiation (p < 0.001, p < 0.001 and p < 0.001, respectively). UICC stage and T stage were found significantly correlated to negative expression of GST pi in cytoplasm (p < 0.001 and p = 0.004, respectively) and cytoplasm/nucleus (p = 0.017 and p = 0.031, respectively). In univariate analysis, absent of GST pi protein expression in cytoplasm, nucleus and cytoplasm/nucleus was significantly associated with a shorter overall survival (p < 0.001, p < 0.001 and p < 0.001, respectively), whereas only GST pi cytoplasmic staining retained an independent prognostic significance (p < 0.001) in multivariate analysis. Conclusions Our results show that GST pi expression is down regulated in the squamous esophageal carcinoma, and that the lack of GST pi expression is associated with poor prognosis. Therefore, deficiency of GST pi protein expression may be an important mechanism involved in the carcinogenesis and progression of the squamous esophageal carcinoma, and the underlying mechanisms leading to decreased GST pi expression deserve further investigation.

2010-01-01

394

The functional interplay between EGFR overexpression, hTERT activation, and p53 mutation in esophageal epithelial cells with activation of stromal fibroblasts induces tumor development, invasion, and differentiation.  

PubMed

Esophageal cancer is a prototypic squamous cell cancer that carries a poor prognosis, primarily due to presentation at advanced stages. We used human esophageal epithelial cells as a platform to recapitulate esophageal squamous cell cancer, thereby providing insights into the molecular pathogenesis of squamous cell cancers in general. This was achieved through the retroviral-mediated transduction into normal, primary human esophageal epithelial cells of epidermal growth factor receptor (EGFR), the catalytic subunit of human telomerase (hTERT), and p53(R175H), genes that are frequently altered in human esophageal squamous cell cancer. These cells demonstrated increased migration and invasion when compared with control cells. When these genetically altered cells were placed within the in vivo-like context of an organotypic three-dimensional (3D) culture system, the cells formed a high-grade dysplastic epithelium with malignant cells invading into the stromal extracellular matrix (ECM). The invasive phenotype was in part modulated by the activation of matrix metalloproteinase-9 (MMP-9). Using pharmacological and genetic approaches to decrease MMP-9, invasion into the underlying ECM could be suppressed partially. In addition, tumor differentiation was influenced by the type of fibroblasts within the stromal ECM. To that end, fetal esophageal fibroblasts fostered a microenvironment conducive to poorly differentiated invading tumor cells, whereas fetal skin fibroblasts supported a well-differentiated tumor as illustrated by keratin "pearl" formation, a hallmark feature of well-differentiated squamous cell cancers. When inducible AKT was introduced into fetal skin esophageal fibroblasts, a more invasive, less-differentiated esophageal cancer phenotype was achieved. Invasion into the stromal ECM was attenuated by genetic knockdown of AKT1 as well as AKT2. Taken together, alterations in key oncogenes and tumor suppressor genes in esophageal epithelial cells, the composition and activation of fibroblasts, and the components of the ECM conspire to regulate the physical and biological properties of the stroma. PMID:17974918

Okawa, Takaomi; Michaylira, Carmen Z; Kalabis, Jiri; Stairs, Douglas B; Nakagawa, Hiroshi; Andl, Claudia D; Johnstone, Cameron N; Klein-Szanto, Andres J; El-Deiry, Wafik S; Cukierman, Edna; Herlyn, Meenhard; Rustgi, Anil K

2007-11-01

395

The functional interplay between EGFR overexpression, hTERT activation, and p53 mutation in esophageal epithelial cells with activation of stromal fibroblasts induces tumor development, invasion, and differentiation  

PubMed Central

Esophageal cancer is a prototypic squamous cell cancer that carries a poor prognosis, primarily due to presentation at advanced stages. We used human esophageal epithelial cells as a platform to recapitulate esophageal squamous cell cancer, thereby providing insights into the molecular pathogenesis of squamous cell cancers in general. This was achieved through the retroviral-mediated transduction into normal, primary human esophageal epithelial cells of epidermal growth factor receptor (EGFR), the catalytic subunit of human telomerase (hTERT), and p53R175H, genes that are frequently altered in human esophageal squamous cell cancer. These cells demonstrated increased migration and invasion when compared with control cells. When these genetically altered cells were placed within the in vivo-like context of an organotypic three-dimensional (3D) culture system, the cells formed a high-grade dysplastic epithelium with malignant cells invading into the stromal extracellular matrix (ECM). The invasive phenotype was in part modulated by the activation of matrix metalloproteinase-9 (MMP-9). Using pharmacological and genetic approaches to decrease MMP-9, invasion into the underlying ECM could be suppressed partially. In addition, tumor differentiation was influenced by the type of fibroblasts within the stromal ECM. To that end, fetal esophageal fibroblasts fostered a microenvironment conducive to poorly differentiated invading tumor cells, whereas fetal skin fibroblasts supported a well-differentiated tumor as illustrated by keratin “pearl” formation, a hallmark feature of well-differentiated squamous cell cancers. When inducible AKT was introduced into fetal skin esophageal fibroblasts, a more invasive, less-differentiated esophageal cancer phenotype was achieved. Invasion into the stromal ECM was attenuated by genetic knockdown of AKT1 as well as AKT2. Taken together, alterations in key oncogenes and tumor suppressor genes in esophageal epithelial cells, the composition and activation of fibroblasts, and the components of the ECM conspire to regulate the physical and biological properties of the stroma.

Okawa, Takaomi; Michaylira, Carmen Z.; Kalabis, Jiri; Stairs, Douglas B.; Nakagawa, Hiroshi; Andl, Claudia; Johnstone, Cameron N.; Klein-Szanto, Andres J.; El-Deiry, Wafik S.; Cukierman, Edna; Herlyn, Meenhard; Rustgi, Anil K.

2007-01-01

396

A new device for measuring esophageal variceal pressure  

Microsoft Academic Search

Background: Esophageal varices are a frequent source of bleeding in patients with cirrhosis. Elevated intravariceal pressure is associated with variceal bleeding. There is no simple, easy-to-use device for noninvasive measurement of intravariceal pressure. The purposes of this study were to develop a noninvasive method for measuring intravariceal pressure, and to develop a model of esophageal varices that can be used

Elan S. Miller; Joseph K. Kim; Jasneet Gandehok; Mak Hara; Qing Dai; Aslam Malik; Aaron Miller; Larry Miller

2002-01-01

397

Eosinophilic Esophagitis: Red on Microscopy, White on Endoscopy  

Microsoft Academic Search

Background\\/Aims: The presenting symptom of eosinophilic esophagitis, a chronic TH2-type inflammatory disease, is uniform dysphagia attacks. Histology reveals a dense mucosal infiltration with eosinophils. Unfortunately, endoscopic findings are often unremarkable or misleading. This study characterizes the endoscopic manifestations of eosinophilic esophagitis and analyzes the nature and clinical features of the frequently observed white alterations. Methods: Thirty adult patients (22 males,

Alex Straumann; Hans-Peter Spichtin; Kathleen A. Bucher; Pius Heer; Hans-Uwe Simon

2004-01-01

398

Long-term survival after photodynamic therapy for esophageal cancer  

Microsoft Academic Search

Background\\/Aims: Photodynamic therapy (PDT) has been adapted to the endoscopic treatment of digestive cancer, but its indications and efficacy remain uncertain. The aim of this study was to assess its feasibility in the curative treatment of small esophageal tumors. Methods: From 1983 to 1991, PDT was used to treat 123 patients with esophageal cancer who were recommended for nonsurgical treatment

Alain Sibille; René Lambert; Jean-Christophe Souquet; Ghislaine Sabben; Françoise Descos

1995-01-01

399

Esophageal Bacteria and Barrett's Esophagus: A Preliminary Report  

Microsoft Academic Search

The objective of this study was to investigate if esophageal bacteria are associated with Barrett's esophagus (BE). This study was comprised of a retrospective (Part 1) and a subsequent prospective (Part 2) study. In Part 1, Gram stains were performed on esophageal biopsy specimens obtained in 47 patients. Bacteria were quantitated from 0 to 4. In Part II, Gram stains

Glenn L. Osias; Matthew Q. Bromer; Rebecca M. Thomas; David Friedel; Larry S. Miller; Byungse Suh; Bennett Lorber; Henry P. Parkman; Robert S. Fisher

2004-01-01

400

Vitamin supplement use and risk for oral and esophageal cancer  

Microsoft Academic Search

In a hospital?based case?control study, 290 oral cancer cases and 133 esophageal cancer cases were queried as to smoking status, alcohol consumption, and dietary exposures, including vitamin supplement history. Among oral cancer cases, vitamin E use appeared to exert a protective effect. Vitamins C and E had protective effects among esophageal cancer cases. When stratified by smoking status, the protective

Jeanine Barone; Emanuela Taioli; James R. Hebert; Ernst L. Wynder

1992-01-01

401

Early dilation in the treatment of esophageal disruption.  

PubMed

During the past four years, 11 patients with disruption of esophageal continuity have received dilation therapy prior to the healing of the fistula. In 7 patients undergoing transhiatal esophagectomy with a cervical esophagogastric anastomosis, anastomotic leaks within 2 to 13 days (average, 8 days) after operation were treated by drainage, bedside esophageal dilations to at least a 46F bougie, and supplemental jejunostomy tube feedings. Bougienage was performed within 1 to 12 days (average, 6 days) of the diagnosis of a leak, and oral intake was not discontinued for more than 72 hours average. Fistula drainage stopped within 1 to 12 days (average, 6 days) of dilation in all patients. Four patients referred with chronic intrathoracic esophageal disruptions (2, middle third and 2, distal third) following resection of diverticula (2), esophageal dilation (1), and trauma from Harrington rods (1) were also treated successfully by drainage, esophageal dilation, or both. Periesophageal inflammation associated with an esophageal leak, esophageal spasm due to local irritation, or relative anastomotic narrowing may all contribute to obstruction distal to an esophageal disruption and adversely affect spontaneous closure. Dilation of the leaking esophagus is not dangerous if performed carefully and selectively, and in fact may promote healing of the injury. PMID:3778004

Orringer, M B; Lemmer, J H

1986-11-01

402

Genetics Home Reference: Esophageal atresia/tracheoesophageal fistula  

MedlinePLUS

... literature OMIM Genetic disorder catalog Conditions > Esophageal atresia/tracheoesophageal fistula (often shortened to EA/TEF ) On this page: ... August 2012 What is EA/TEF? Esophageal atresia/tracheoesophageal fistula (EA/TEF) is a condition resulting from abnormal ...

403

Esophageal Atresia and Tracheoesophageal Fistula: Surgical Experience Over Two Decades  

Microsoft Academic Search

Background. Despite improvements in survival, for infants born with esophageal atresia tracheoesophageal fistula, or both, the morbidity associated with repair of these anomalies remains high.Methods. This report retrospectively analyzes 81 patients with esophageal atresia, tracheoesophageal fistula, or both presenting to our institution between 1975 and 1995, with a focus on anastomotic complications.Results. There were 46 male and 35 female patients

Josephine Y Tsai; Leah Berkery; David E Wesson; S. Frank Redo; Nitsana A Spigland

1997-01-01

404

Photodynamic Therapy for Barrett's Esophagus and Esophageal Carcinoma  

PubMed Central

This paper reviews the use of photodynamic therapy (PDT) in patients with Barrett's esophagus and esophageal carcinoma. We describe the history of PDT, mechanics, photosensitizers for PDT in patients with esophageal disease. Finally, we discuss its utility and limitations in this setting.

Qumseya, Bashar J.; David, Waseem

2013-01-01

405

Lipoblastoma with unique localization requiring tracheal and esophageal resection.  

PubMed

Lipoblastoma and lipoblastomatosis are rare tumors of infancy. They originate from embryonic fat and localize in soft tissues. We present the case of a lipoblastoma of the neck with localization in tracheal and esophageal walls that required an extended laryngotracheal and esophageal resection. To our knowledge, this is the first report of such localization of this tumor. PMID:20920704

Torre, Michele; Borel, Cecilia; Saitua, Francisco; Ossandon, Francisco; Latorre, Juan Jose; Varela, Patricio

2010-10-01

406

Celecoxib (Celebrex) Increases Canine Lower Esophageal Sphincter Pressure  

Microsoft Academic Search

Background. Prostaglandins inhibit the contraction of gastrointestinal smooth muscle and may decrease lower esophageal sphincter tone. The purpose of this study was to determine whether the cyclooxygenase-2 inhibitor celecoxib (Celebrex) could increase lower esophageal pressure (without affecting gastric emptying) compared to placebo and cisapride (Prepulsid), a compound previously used to treat reflux disease.Materials and methods. Six mongrel dogs were assigned

Sebastian G. de la Fuente; Ross L. McMahon; Erik M. Clary; Mary B. Harris; D. Curtis Lawson; James D. Reynolds; W. Steve Eubanks; Theodore N. Pappas

2002-01-01

407

Esophageal laceration and obstruction caused by a foreign body in 2 young foals  

PubMed Central

This report describes 2 foals with esophageal laceration due to ingestion of foreign bodies. Endoscopic examination of the esophagus revealed full thickness esophageal laceration in 1 colt and partial thickness laceration of the esophagus in the other. The esophageal obstruction was relieved by repetitive esophageal lavages and flush under general anesthesia in both foals.

Abutarbush, Sameeh M.

2011-01-01

408

Comparison of esophageal manometry, provocative testing, and ambulatory monitoring in patients with unexplained chest pain  

Microsoft Academic Search

Prolonged ambulatory esophageal pH and pressure monitors are being developed to evaluate noncardiac chest pain. This new technology needs comparison with conventional esophageal tests before determining which studies are most useful in diagnosing and treating esophageal chest pain. Therefore, we studied 45 patients with esophageal manometry, acid perfusion and edrophonium tests, and 24 hr pH and pressure monitoring. Manometry was

Edward G. Hewson; Christine B. Dalton; Joel E. Richter

1990-01-01

409

Reflux Esophagitis: Sequelae and Differential Diagnosis in Infants and Children Including Eosinophilic Esophagitis  

Microsoft Academic Search

Gastroesophageal reflux disease (GERD) is a common condition in infants and children and has many clinical mimics. Most pediatric pathology departments process many mucosal biopsies from the proximal gastrointestinal tract to evaluate the presence or absence of reflux esophagitis. Since this subject was last reviewed in the 1997 edition of Perspectives in Pediatric Pathology devoted to gastrointestinal diseases in children

Beverly Barrett Dahms

2004-01-01

410

Coronary spasm reflects inputs from adjacent esophageal system.  

PubMed

Mechanisms underlying coronary spasm are still poorly understood. The aim of the study was to assess the hypothesis that fluctuations in the development of coronary spasm might reflect inputs from the adjacent esophageal system. We enrolled patients admitted to the coronary care unit for episodes of nocturnal angina. Seven patients with variant angina and five with coronary artery disease (CAD) had concurrent ECG and esophageal manometric monitoring. ECG monitoring documented 28 episodes of ST elevation in variant angina patients and 16 episodes of ST depression in CAD patients. Manometric analysis showed that esophageal spasms resulted remarkably more frequently in variant angina patients (143 total spasms; individual range 9-31) than in CAD patients (20 total spasms; individual range 0-9; P < 0.01). Time series analysis was used to assess fluctuations in the occurrence of abnormal esophageal waves and its relationship with spontaneous episodes of ST shift. Episodes of esophageal spasm in CAD were sporadic (<1 in 30 min) and not related to ECG-recorded ischemia. In the variant angina group, esophageal spasms were time related to ischemia (>1 into 5 min before ECG-recorded ischemia) (P < 0.05). A bidirectional analysis of causal effects showed that the influence processes between esophageal and coronary spasms were mutual and reciprocal (transfer function model, P < 0.05) in variant angina. We concluded that in variant angina patients, episodes of esophageal spasms and myocardial ischemia influenced each other. Mechanisms that cause esophageal spasm can feed back to produce coronary spasm. Coronary spasm may feed forward to produce additional episodes of esophageal spasm. PMID:16387792

Manfrini, Olivia; Bazzocchi, Gabriele; Luati, Alessandra; Borghi, Alberigo; Monari, Paola; Bugiardini, Raffaele

2005-12-30

411

Study of metabonomic profiles of human esophageal carcinoma by use of high-resolution magic-angle spinning 1H NMR spectroscopy and multivariate data analysis.  

PubMed

Esophageal carcinoma (EC) is one of the most common malignant tumors. EC survival has remained disappointingly low because of the high malignancy of esophageal cancer and the lack of obvious clinical symptoms at an early stage. Early diagnosis is often difficult because the small tumor nodules are frequently missed. Metabonomics based on high-resolution magic-angle spinning (HRMAS) NMR has been popular for tumor detection because it is highly sensitive, provides rich biochemical information and requires no sample pretreatment. (1)H HRMAS spectra of non-involved adjacent esophageal tissues and of well differentiated and moderately differentiated esophageal carcinoma tumors were recorded and analyzed by use of multivariate and statistical analysis techniques. Moderately differentiated EC tumors were found to have increased total choline, alanine, and glutamate and reduced creatine, myo-inositol, and taurine compared with non-involved adjacent tissues. Moreover, clear differences between the metabonomic profiles of EC tissues enabled tumor differentiation. Furthermore, the integral Gly/MI ratio for samples of different tissue types were statistically significantly different; this was sufficient both for distinguishing non-involved tissues from esophageal carcinoma and for classification of well differentiated and moderately differentiated EC tumors. PMID:23455688

Yang, Yongxia; Wang, Lijing; Wang, Shumei; Liang, Shengwang; Chen, Ali; Tang, Huiru; Chen, Lei; Deng, Feng

2013-03-03

412

Exercise-triggered transient R-wave enhancement and ST-segment elevation in II, III, and aVF ECG leads: a testament to the "plasticity" of the QRS complex during ischemia.  

PubMed

We describe a patient with coronary artery disease who showed transiently augmented R-waves in his electrocardiogram (ECG) during the course of an exercise treadmill test (ETT), an ECG pattern occasionally associated with the hyperacute phase of myocardial infarction and variant angina. This change in the R-waves was noted in II, III, and aVF ECG leads and was associated with ST-segment elevation; both changed gradually and were normalized during the recovery period. Cardiac enzymes after ETT were negative, and arteriography revealed 3-vessel coronary artery disease, with a completely occluded right coronary artery. The ventriculogram showed very mild hypokinesis of the inferior left ventricular wall, while the global ejection fraction was 75%. These ECG changes, noted previously during ETT in precordial ECG leads, are herein reported to occur also in II, III, and aVF ECG leads. The generation of these ECG changes, which hinges upon a late unopposed depolarization occurring in the course and at the site of severe ischemic injury, constitutes a transient focal ventricular conduction abnormality. PMID:15127379

Madias, John E; Attari, Mehran

2004-04-01

413

Upper esophageal sphincter during transient lower esophageal sphincter relaxation: effects of reflux content and posture  

PubMed Central

Although some studies show that the upper esophageal sphincter (UES) contracts during transient lower esophageal sphincter relaxation (TLESR), others show that it relaxes. We hypothesized that the posture of the subject and constituents of gastroesophageal reflux (GER) may determine the type of UES response during the TLESR. High-resolution manometry and esophageal pH/impedance recording were performed in 10 healthy volunteers in the right recumbent (1 h) and upright (1 h) positions following the ingestion of a 1,000-Kcal meal. The UES pressure response during TLESR and constituents of GER (liquid, air, and pH) were determined. 109 TLESRs (58 upright and 51 recumbent) were analyzed. The majority of TLESRs were associated with GER (91% upright and 88% recumbent) events. UES relaxation was the predominant response during upright position (81% of TLESRs), and it was characteristically associated with presence of air in the reflux (92%). On the other hand, UES contraction was the predominant response during recumbent position (82% of TLESRs), and it was mainly associated with liquid reflux (71%). The rate of esophageal pressure increase (dP/dt) during the GER, but not the pH, had major influence on the type of UES response during TLESR. The dP/dt during air reflux (127 ± 39 mmHg/s) was significantly higher than liquid reflux (31 ± 6 mmHg/s, P < 0.0001). We concluded that the nature of UES response during TLESR, relaxation or contraction, is related to the posture and the constituents of GER. We propose that the rapid rate of esophageal pressure increase associated with air reflux determines the UES relaxation response to GER.

Babaei, Arash; Bhargava, Valmik

2010-01-01

414

IGF-1 and Its Receptor in Esophageal Cancer: Association with Adenocarcinoma and Visceral Obesity  

Microsoft Academic Search

OBJECTIVES:The insulin-like growth factor (IGF) pathway and visceral obesity have been independently linked with esophageal cancer. This study aimed to delineate the differential and interlinked role of visceral obesity and the IGF-1 system in esophageal adenocarcinoma and esophageal squamous-cell carcinoma (SCC).METHODS:IGF-1 receptor (IGF-1R) mRNA and protein were examined in esophageal SCC (KYSE 410, OE21) and esophageal adenocarcinoma (OE19, OE33) cell

Suzanne L Doyle; Claire L Donohoe; Stephen P Finn; Julia M Howard; Fiona E Lithander; John V Reynolds; Graham P Pidgeon; Joanne Lysaght

2012-01-01

415

Evolution in surgical management of esophageal cancer.  

PubMed

Esophageal resection remains the primary treatment for local regional esophageal cancer, although its role in superficial (T1A) cancers and squamous cell cancer is in evolution. Mortality associated with esophagectomy has historically been high but is improving with the current expectation of in-hospital mortality rates of 2-4% in high-volume centers. Most patients with regional cancers (T2-4 N0-3) are recommended for neoadjuvant therapy, which most commonly involves radiochemotherapy. Some centers have proposed treating with definitive chemoradiation and reserving surgery for patients who have persistent or recurrent disease. 'Salvage resections' are possible but are associated with higher levels of perioperative morbidity and mortality, and treatment decisions should routinely be based on multidisciplinary discussion in the tumor board. Although open surgical resection (both transthoracic and transhiatal operations) remain the most common approach, minimally invasive or hybrid operations are being done in up to 30% of procedures internationally. There are some indications that minimally invasive esophagectomy may decrease the incidence of respiratory complications and decrease length of stay. At this point, oncologic outcomes appear equivalent between open and minimally invasive procedures. Recent reviews from high-volume esophagectomy centers demonstrate that elderly patients can selectively undergo esophagectomy with the expectation of increased complications but similar mortality and survival to younger patients. Multiple studies confirm that quality of life following esophagectomy can be equivalent to the general population when surgery is done in experienced centers. Patients requiring surgical treatment of esophageal cancer should be referred to high-volume centers, especially those with established care pathways or enhanced recovery programs to improve outcomes including morbidity, mortality, survival, and quality of life. PMID:23797119

Low, Donald E

2013-06-17

416

Comparative Study of Esophageal Stent and Feeding Gastrostomy/Jejunostomy for Tracheoesophageal Fistula Caused by Esophageal Squamous Cell Carcinoma  

PubMed Central

Background A malignant tracheoesophageal/bronchoesophageal fistula (TEF) is a life-threatening complication of esophageal squamous cell carcinoma. A feeding gastrostomy/jejunostomy had been the most common treatment method for patients with TEF before the era of stenting. The aim of this retrospective study is to compare the prognosis of esophageal squamous cell carcinoma patients with TEF treated with an esophageal metallic stent to those treated with a feeding gastrostomy/jejunostomy. Methods We retrospectively reviewed a total of 1011 patients with esophageal squamous cell carcinoma between 1996 and 2011 at Kaohsiung Chang Gung Memorial Hospital, and 86 patients with TEF (8.5%) were identified. The overall survival and other clinical data were compared between 30 patients treated with an esophageal metallic stent and 35 patients treated with a feeding gastrostomy/jejunostomy. Results Among the 65 patients receiving either an esophageal metallic stent or a feeding gastrostomy/jejunostomy, univariate analysis showed that treatment modality with an esophageal metallic stent (P?=?0.007) and radiotherapy treatment after fistula diagnosis (P?=?0.04) were predictive of superior overall survival. In the multivariate comparison, treatment modality with an esophageal metallic stent (P?=?0.026, odds ratio: 1.859) represented the independent predictive factor of superior overall survival. There were no significant differences between groups in mean decrease in serum albumin or mean body weight loss. Compared to the feeding gastrostomy/jejunostomy group, a significantly higher proportion of patients in the stenting group (53% versus 14%, P?=?0.001) were able to receive chemotherapy within 30 days after fistula diagnosis, indicating better infection control in the stenting group. Conclusions Compared with a feeding gastrostomy/jejunostomy, an esophageal metallic stent significantly improves overall survival in patients with malignant TEF in our retrospective analysis. Esophageal metallic stent placement may be considered the first-line of treatment for patients with malignant TEF.

Chiu, Yi-Chun; Lu, Hung-I; Huang, Cheng-Hua; Rau, Kun-Ming; Liu, Chien-Ting

2012-01-01

417

Complications of gastroesophageal reflux disease. Role of the lower esophageal sphincter, esophageal acid and acid/alkaline exposure, and duodenogastric reflux.  

PubMed Central

The factors contributing to the development of esophageal mucosal injury in gastroesophageal reflux disease (GERD) are unclear. The lower esophageal sphincter, esophageal acid and acid/alkaline exposure, and the presence of excessive duodenogastric reflux (DGR) was evaluated in 205 consecutive patients with GERD and various degrees of mucosal injury (no mucosal injury, n = 92; esophagitis, n = 66; stricture, n = 19; Barrett's esophagus, n = 28). Manometry and 24-hour esophageal pH monitoring showed that the prevalence and severity of esophageal mucosal injury was higher in patients with a mechanically defective lower esophageal sphincter (p less than 0.01) or increased esophageal acid/alkaline exposure (p less than 0.01) as compared with those with a normal sphincter or only increased esophageal acid exposure. Complications of GERD were particularly frequent and severe in patients who had a combination of a defective sphincter and increased esophageal acid/alkaline exposure (p less than 0.01). Combined esophageal and gastric pH monitoring showed that esophageal alkaline exposure was increased only in GERD patients with DGR (p less than 0.05) and that DGR was more frequent in GERD patients with a stricture or Barrett's esophagus. A mechanically defective lower esophageal sphincter and reflux of acid gastric juice contaminated with duodenal contents therefore appear to be the most important determinants for the development of mucosal injury in GERD. This explains why some patients fail medical therapy and supports the surgical reconstruction of the defective sphincter as the most effective therapy.

Stein, H J; Barlow, A P; DeMeester, T R; Hinder, R A

1992-01-01

418

Primary esophageal meningioma: first literature report.  

PubMed

We have described a primary esophageal meningioma (MG) clinical case diagnosed in a 62-year-old woman; also, we review the literature about extracranial MGs. To our knowledge, this is the first case report of an extracranial MG occurring primarily in the esophagus. These are benign neoplasms reported classically in the central nervous system (CNS). The extrancranial MGs have histopathologic and inmunohistochemical features identical to those observed in CNS MGs; thus, the main diagnostic hurdle is to keep it in the differential for lesions occurring outside the CNS. PMID:22647829

Romero-Rojas, Alfredo E; Diaz-Perez, Julio A; Amaro, Deirdre; Messa-Botero, Oscar A; Castilla, Elias A

2013-01-01

419

Medical management of patients with reflux esophagitis.  

PubMed

Medical management of reflux esophagitis includes physical manipulations, antacids, and antireflux medications (bethanechol and alginic acid). Their combined usage in the continuous dyspeptic and the problem case help "break the cycle," providing relief for long periods of time. Identification of possible inciting factors in cases of recurrence should be pointed out to the patient so that he will develop an instinctive antireflux behavior. The effect of this combined therapy on the pathophysiology and natural history of the disease remains to be determined. PMID:628873

Roufail, W M

1978-01-01

420

Treatment of esophageal spirocercosis with milbemycin oxime.  

PubMed

Six medium sized mixed breed dogs treated with milbemycin oxime (11.5mg on days 0, 7 and 28 and then monthly) stopped shedding Spirocerca lupi ova after 3-44 days. There was no evidence of subsequent shedding in repeated tests (about 5/dog) carried out from 31 to 133 days after initiation of treatment. Esophageal nodules disappeared in all dogs within 95-186 days and radiographic signs resolved within 85-127 days in the five dogs that were studied. This preliminary data shows milbemycin oxime deserves further evaluation for the treatment of spirocercosis. PMID:18644677

Kelly, P J; Fisher, M; Lucas, H; Krecek, R C

2008-06-20

421

Unusual esophageal foreign body: a table fork.  

PubMed

The presence of an esophageal foreign body (EFB) is a medical emergency requiring urgent evaluation and treatment. Swallowing of foreign bodies is most common in children aged between 6 months and 6 years, in whom it usually occurs during games. In adults, foreign bodies tend to be ingested accidentally together with food. The authors report an unusual case of EFB (a table fork) in an adult and briefly report the clinical presentation and the therapeutic procedures adopted in this case and similar cases. PMID:23634316

Mevio, Emilio; Mevio, Niccolò

2013-03-24

422

Study to Investigate the Effects of Skin Friction on the Performance of Drilled Shafts in Cohesive Soils. Volumes I, II, III.  

National Technical Information Service (NTIS)

The general objective of this study was to investigate the effects of skin friction on performance of drilled shafts in cohesive soils. The investigation was conducted and discussed here in three stages: field, laboratory, and theoretical analyses. Four t...

J. Audibert D. Aggarwal W. Gardner R. Singh G. Baker

1982-01-01

423

Biomarkers of apoptosis and survival in esophageal squamous cell carcinoma  

PubMed Central

Background Cancer of the esophagus is a deadly malignancy, and development of biomarkers that predict survival is an urgent need. The apoptotic pathways have been hypothesized as important in progression of esophageal squamous cell carcinoma (ESCC). We investigated a panel of proteins that regulate apoptosis as candidate of biomarkers of prognosis in ESCC. Methods Tissue microarray (TMA) including 313 surgically-resected cases of ESCC specimens was built for immunohistochemical interrogation. We evaluated seven genes in the FasL-Fas apoptotic pathway - FasL, Fas, FAS-associated death domain protein (FADD), phosphorylated-FADD, and caspase 8 and 10, and the antiapoptotic protein bcl-2. We studied pathway integrity and relations to risk and clinical factors, and determined the prognostic significance of each marker. Results Five markers showed strong inter-marker correlations (r ? 0.28, p < 0.001), including FasL, Fas, FADD, and caspases 8 and 10. FasL and FADD also showed modest correlations with one or more cancer risk factors, but none of the markers was significantly associated with either tumor stage or lymph node metastasis, the only two clinical factors that predicted survival in these ESCC cases. Multivariate-adjusted proportional hazard regression models showed no association between protein expression and risk of death for any of the seven markers examined. Conclusion Individual biomarkers in the apoptosis pathway do not appear to predict survival of patients with ESCC.

2009-01-01

424

Collaborative Stage  

Cancer.gov

Required SEER Site-Specific Factors for Collaborative Stage - This tool highlights the site-specific factors (SSF) required for staging, obsolete SSF’s, clinically significant SSFs, as well as those not required.